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The Standing Committee on Health

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The Standing Committee on Health Committees as Agents of Public Policy: The Standing Committee on Health by Bonnie Brown MP in collaboration with Nancy Miller Chenier and Sonya Norris Long before phrases such as "democratic deficit" and "empowerment of MPs" be- 2003 CanLIIDocs 247 came fashionable the 1985 Report of the Special Committee on Reform of the House of Commons (McGrath Report) called for a strengthened role for standing committees of the House in shaping public policy. It recommended "wider use of parliamentary committees to review draft legislation, to conduct general inquiries when policy choices have not been made, and to bring in draft bills." Overall, it insisted that standing committees should play an important part in influencing policy through the legislative process. As a result the Standing Orders were modified to allow some Bills to be send to committee before Second Reading. This has been done on a few oc- casions. However it was not until very recently that the government went even fur- ther and following the recommendation of the McGrath Report asked a Parliamentary Commit tee to review and report on draft legislation before it was even introduced in the House. The issue was assisted human reproduction and in 2001, Allan Rock, Minister of Health, asked the Standing Committee on Health to examine and formulate policy on this complex and controversial topic. This article reflects upon the use of this approach to giving members of Parliament a greater role in the legislative and policy process. when the Health Committee made 293 recommendations. A central recommendation began its consultation, declared that reproductive technologies required a assisted human reproduction federal legislative framework immediately to implement had for more than a decade been the prohibitions in areas such as selling human eggs, sperm, focus of numerous government and zygotes, or fetal tissue; advertising for, paying for, or societal activities. From 1989 to 1993, a acting as an intermediary for surrogacy; and using Royal Commission on the New embryos in research related to cloning. The report also Reproductive Technologies (RCNRT) focused on the creation of the National Reproductive studied the social, ethical, health, Technologies Commission (NRTC) to oversee licensing research, legal and economic implications. In its lengthy and to monitor reproductive technologies and practices. 1993 report entitled Proceed with Care, the Commission In 1995, then Health Minister, Diane Marleau an- nounced a voluntary moratorium on certain related practices, such as cloning of human embryos, commer- Bannie Brown has represented Oakville in the House of Commons cial surrogacy, buying and selling of eggs, sperm and since 1993. She is Chair of the Standing Committee on Health. Nancy embryos, and other activities that were deemed to be un- Miller Chenier and Sonya Norris work with the Parliamentary ethical and socially unacceptable. In 1996, the new Min- Research Branch and are advisors to the Health Committee. 4 CANADIAN PARLIAMENTARY REVIEW /AUTUMN 2003 ister of Health, David Dingwall, introduced Bill C-47, The Committee as a Forum for Public Consultation cited as the Human Reproductive and Genetic Technologies Act, in order to establish boundaries around some of the When the Minister of Health approached the Standing technologies and prohibit certain practices. This Bill in- Committee on Health, he wanted an open public avenue cluded addition al prohibitions against the use of human for an examination of the draft legislation on assisted hu- sperm, eggs, or embryos without the informed consent of man reproduction; advice on options for a possible regu- the donor and against research on human embryos later latory body that would govern the implementation of the than 14 days after conception or their creation for re- legislation and monitor developments, and a consider- search purposes only. After receiving some legislative ation of the structure and responsibilities of international scrutiny in a House of Commons sub-committee, the Bill regulatory bodies that oversee similar projects in other died on the order paper with the call of the 1997 general countries. In addition to the readily available evidence election. gathered from witnesses at meetings, the Committee Over the same period and behind the scenes, public would provide overall advice through its report and rec- servants were working on the issues raised by the Royal ommendations. Commission. From 1993 to 1996, Health Canada coordi- 2003 CanLIIDocs 247 nated a Federal-Provincial-Territorial Working Group to Parliamentary committees play a key advise deputy ministers of Health. In 1996, departmental role in organizing public consultation officiais worked with an advisory committee of knowl- edgeable Canadians established to track moratorium through their inquiries into particular compliance and emerging reproductive and genetic subjects. technologies.' In 1999, Health Canada brought forward an overview discussion paper2, and followed the next Public meetings provide a particular focus for public year with a workbook and feedback document.3 interaction and input into policy formulation. They are a Against this background of continuous but incomplete place where Canadians, sometimes as individuals and efforts to regulate assisted human reproduction, Minis- often as representatives of a group, can meet, place their ter Rock turned to the House of Commons Health Com- views on public record, and then examine and react to mittee. In May 2001, he tabled in Parliament a document other views. In the process, Committee members can be- entitled Proposals for Legislation Governing Assisted Human come aware of some of the choices that must be made Reproduction. This draft of the legislation was accompa- among competing ideas and of some of the interests that nied by an implicit commitment to introduce legislation promote specific choices. At the same time, department dependent upon the review by the Committee. officiais and ministerial advisers can use these public fo- rums to stay abreast of any changes in the direction of the The Minister of Health indicated that the federal goy- debate. ernment was ready to move to the comprehensive ap- proach advocated by the RCNRT.4 The Minister had As the Health Committee organized its public meet- reasons to seek the perspectives of a committee repre- ings to gain understanding of the dimensions of assisted senting diverse personal and political views. As he human reproduction, members became aware of the noted, "The issues raised by assisted human reproduc- multiple demands that confront policymakers. Follow- tion leave no one indifferent. They are complex and are ing an initial meeting with the Health Minister, officiais important to many Canadians and to our society as a from the department provided explanatory information whole. The Government believes that it is important at over three meetings. To meet its information needs and this juncture that Canadians and their elected represen- to encourage public participation from involved groups, tatives in Parliament have an opportunity to discuss the the Committee organized meetings that included the for- draft legislation". mer Chair of the Royal Commission on Reproductive In agreeing to review the draft legislative proposais, and Genetic Technologies and members of the Health the Health Committee was consenting to a process seen Canada Advisory Committee on the Interim Morato- rium on Reproductive Technology. Small groups of wit- as one element of crucial reform for parliamentarians. At nesses then addressed issues related to the medical this point, the Standing Committee on Health became: a technologies and medical practices, ethical and faith per- forum for public consultation, a filter for contentious de- spectives, surrogacy, embryonic and adult stem cell re- bate, and an agent for policy development on an issue search, anonymous gamete and embryo donation, that had already consumed more than a decade of debate enforcement and inspection, therapeutic cloning, data- bases, registries and privacy, informed consent, regula- AUTUMN 2003 / CANADIAN PARLIAMENTARY REVIEW 5 tory bodies and federal versus provincial jurisdictional source of advice to the Committee while at the same time issues. keeping the Minister informed of changes in the direc- In the absence of a travel budget, the Committee issued tion of the debate among committee members and of ad- invitations to representatives from provincial govem- ditional or new issues raised by witnesses. ments as well as many fertility clinic directors to attend Addressing the Complexities of Assisted Human Re- meetings in Ottawa. However, these efforts to elicit pub- production lic testimony or written contributions produced little ac- knowledgement from provincial representatives while In the public hearings and in other encounters, the clinic directors seemed to rely on various medical associ- Committee members heard from a wide variety of indi- ations to present their views. In addition to written briefs viduals and groups. They leamed about the many differ- received from individuals affected by infertility, the col- ent outcomes expected and desired from the assisted lective concems of the infertile community were repre- human reproduction legislation. For some, the primary sented on many of the diverse issue panels through concem was the well-being of the children resulting from related associations. the procedures; for others, it was the health and safety of To gain knowledge
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