Scientific Medical Research in Canada

"The government recognizes that Networks of Centres for Excellence have made significant contributions to the research and innovation landscape."
"The federal government remains committed to collaborative teams of Canadian researchers."
Nyree St-Denis, spokesperson for Science Minister Kirsty Duncan, Ottawa

"I think the one thing Canadians are really good at is working together in a collaborative way. This program [the BioCanRx network] brought together people with different interests to solve problems -- and what is a bigger problem than cancer?"
"I think it is a shame that program is discontinued with no clear answer what it is going to be replaced with."
Dr. John Bell, scientific director, BioCanRx, senior scientist, cancer therapeutics, The Ottawa Hospital

"Canada is a leader in stem cell research. Our scientists are incredibly well-regarded. So many of the people we have trained have become leaders."
"Many say this would not have happened without the Stem Cell Network."
Dr. Michael Rudnicki, senior scientist, director, regenerative medicine program, Sprott Centre for Stem Cell Research, The Ottawa Hospital Research Institute

The Canadian government under Prime Minister Justin Trudeau is ending the Networks of Centres of Excellence Program and replacing it with the New Frontiers in Research Fund, designed to support research that is "interdisciplinary, fast-breaking and high-risk". An investment of $275-million over the next five years and $65-million on an ongoing basis has been committed. One can only wonder whether this 'progressive' government that has delighted since coming to power in 2015 in changing the names of government departments to suit its 'gender-inclusive and alt-gender'
message has gone drunk on the power of interference in everything and anything.

"It is disappointing to be cut off a the knees", stated Dr. John Bell, with the devastating news that his groundbreaking immunotherapy research program designed to bring research from the laboratory directly to patients is now in jeopardy, not knowing where its funds will now come from and whether the program can survive at all. There was an anticipated commitment of 15 years of stable funding from its inception in 2014, suddenly swept away on a whim of the federal government to place its obliterating stamp on a program that pre-dated its administration.

Those Networks of Centres of Excellence that are currently practising what they know best remain eligible to apply for three-year funding renewals, after which their funding applications will be cut off since the new fund is specifically directed toward academic researchers, and not meant to fund networks. The shift in the federal government funding of scientific research will impact deleteriously on many such networks.

Established 17 years ago, the Stem Cell Network based in Ottawa also faces uncertainty in financial stability to underwrite its critical work.

The network will be forced, according to officials there, to close by the end of March should no new source of federal support be forthcoming, delivering a dead-end to stem-cell research across the country. The House of Commons Finance Committee has recommended that the next federal budget contain "stable and predictable funding for the Stem Cell Network to maintain operations after March 31, 2019", but this is clearly not the Trudeau administration's order of business.

Ottawa has been recognized as a hotbed for stem cell research with clinical trials using stem-cell therapy to treat heart failure, sepsis and to improve lung function in premature babies.  The director of the Stem Cell Network comments that cutting off funding will create difficulties for researchers to collaborate on precisely this kind of work that has distinguished Canada as a leader in stem cell research.

The use of stem cells and chemotherapy to successfully treat early, aggressive MS, considered a leading breakthrough in treatment of MS, was pioneered by Drs. Harold Atkins and Mark Freedman of The Ottawa Hospital and the University of Ottawa.

According to Dr. Michael Rudnicki, scientific director of the Stem Cell Network, it now becomes impossible to make any commitments for next year, or to sign contracts -- inclusive of agreements with partners for jointly funded programs. Typically, the network's partners would match any amount that would be funded by the federal government in the past. The work of the network is to support researchers, partnering with companies and health charities to bring together people working on stem cell research.

As for BioCanRx which has manufacturing facilities in Ottawa, Victoria and Vancouver, now poised to begin treatment of patients with CAR T-cell therapy where a patient's T cells (a type of immune system cell) are engineered to attack cancer cells, the program's future is now in doubt. Scheduled to produce the first made-in-Canada CAR T-cells that trial is set to proceed irrespective of the funding situation but the uncertainty over funds will impact on future innovation.

Almost thirty years ago, a previous, Conservative-led government had introduced the National Centres of Excellence as a joint funding venture of the Natural Sciences and Engineering Research Council (NSERC), the Social Sciences and Humanities Research Council (SSHRC), the Canadian Institutes of Health Research (CIHR), and Innovation, Science and Economic Development Canada, as a mechanism to fund university-based research centres that operating jointly with private sector companies.

Whatever a Conservative government in Canada can initiate, a Liberal government can dismantle.

Managing Health Costs Out of a Finite Pool

"It's a hard pill to swallow, to be injured like I was by a somewhat minor operation, and to have your life destroyed by it. To then have to battle the whole government machine adds a whole other layer of anger and frustration."
"The pain was so extreme [from her unsuccessful foot operation] that I couldn't imagine a life with it."
"I think it's fundamentally unjust [that the Ontario universal health care plan will not reimburse patients for self-selected out-of-province surgery]. There is no process in place that allows for fairness in funding."
Michelle Fernandes, former broadcast executive, recreational runner

"It's a blatantly rigged process. I've seen too man people pay all these outrageous taxes over the years, and then the system completely fails them."
Dr. Jeff Brock, CEO MedExtra

"There are a number of places [shady quasi-medical enterprises] that will take people with late-stage disease and 'give it a shot'."
"Sometimes there is a disingenuous promise from another [medical] centre [outside Canada]."
Terry Sullivan, health-policy professor, University of Toronto

The Ontario Liberals are projecting overall spending growth of just 1.2 per cent on hospitals, doctors and other services – an increase that is less than half the size of last year’s and well short of inflation and population growth.    (Kevin Van Paassen/The Globe and Mail)

 

The issue for the Ontario Health Ministry in deciding what will be covered by the finite funds used to ensure that provincial residents obtain their universal health care needs in coverage that scoops up most, but not all needs associated with furnishing that health care, is to limit what they perceive as coverage for extraneous, unauthorized services. There are wait times for many surgical procedures that are not considered of an emergency linkage.

And sometimes patients become impatient and look for treatment outside Canada. Aside from those interminable-seeming surgical wait times, often the type of treatment sought may be experimental in nature and not approved by Health Canada, from stem-cell therapies obtainable in Mexico, to multiple-sclerosis procedures in Poland whose actual merit in answering the medical-health needs of patients is questionable, or research does not support these procedures.

The Canadian medical community and the services provided are conventional in nature, services proven over time to be successful. In the United States there are fewer constraints where the medical system tends to be more entrepreneurial in the sense that often claims are made for successful interventions that are not merited by reality, but they tend to draw people in who believe they will be  helped.

Dr. Sullivan with University of Toronto was a former Ontario Health Ministry official who argues from experience that the system used by Ontario in its health policies formulations is capable of adequately identifying cases deserving of funding. Michelle Fernandes who looked elsewhere than within Canada to solve her problem that resulted from an operation that had not been successful, disagrees.

She had been a director of research at a media firm, had run competitively in the Chicago marathon, taken part in 400-kilometre cycling events and was in generally fit health.She developed ankle bone spurs and an operation was scheduled in 2005. The surgeon inadvertently damaged a number of nerves leaving her in excruciating pain that left her little option but to leave her job since she was effectively bedridden for three years.

She was in so much pain that at age 47 and unable to sleep, she contemplated suicide. No Canadian specialists she consulted felt they could help her. And then she contacted a surgeon in the United States and made arrangements for surgeries to take place there. At a cost of $200,000. Little wonder it seems unfair to her that through no fault of her own, her health dreadfully impaired by a surgeon whose technique was lacking and yet the Ontario Health Ministry refuses to reimburse her.

A provincial appeal board upheld the government's position. When Canadians seek out health care in another country, the provinces are loathe to pay for services received. Patients are enjoined to seek official approval from the ministry for funding before undertaking a foreign medical service. Under the Health Ministry's rules foreign treatment must not be of an experimental nature and nor should the service be of a kind available in Canada.

In fact, the Ministry itself often sends patients outside Canada in reflection of any service gaps in the province. As for pre-authorization of payment for services received abroad, very few applications ever get approved, explained a former lawyer for the Ontario Health Insurance Program. And when patients appeal their OHIP denial of funding, the Health Services Appeal and Review Board turns down 82 percent of those cases.

Through her general practitioner Ms. Fernandes consulted "dozens and dozens" of specialists; neurosurgeons and orthopedic surgeons in Ontario and other provinces, to no avail, leading them to the conclusion they would be required to look for the needed help outside Canada.

In 2006 the first of ten surgeries took place for Ms. Fernandes with a peripheral-nerve specialist at Johns Hopkins University in Baltimore. Imaging was used to identify the location of the damaged nerves which were then removed one by one. Each time this occurred Fernandes' condition was improved.

Now, a doctor who had received training under one of the Johns Hopkins surgeons' collaborators is at the present time in practise in Toronto. And it is this practitioner whom Fernandes relied upon for her latest surgery, at medicare's expense.