Bill C-442 (Historical)

National Lyme Disease Strategy Act

An Act respecting a National Lyme Disease Strategy

This enactment requires the Minister of Health to convene a conference with the provincial and territorial ministers responsible for health and with representatives of the medical community and patients’ groups for the purpose of developing a national strategy to address the challenges of the recognition and timely diagnosis and treatment of Lyme disease. It also authorizes the Minister of Finance to establish guidelines in respect of the allocation of funding to provincial and territorial governments that have enacted legislation to implement that strategy.

National Lyme Disease Strategy Act

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

, seconded by the hon. member for Oakville, moved that Bill C-442, An Act respecting a National Lyme Disease Strategy, be read the second time and referred to a committee.

She said: Mr. Speaker, today I am very honoured to introduce this bill for a national strategy on Lyme disease at second reading. When we are able to work together as members of Parliament, anything is possible.

Today I stand here with the great honour of presenting a bill in my name. If I could, I would remove my name and put the names of all of us on it. This is a truly non-partisan effort, and this is reflected in the process of this legislation in the House so far.

At first reading, in June 2012, the seconder of my bill was my friend the hon. Liberal member for Etobicoke North, who has been very active on many health issues. Today I have the enormous honour of having my bill seconded by the hon. member for Oakville, himself a champion on a number of health issues. I commend him and the Minister of Health, in fact all of the Conservative members, for bringing forward Bill C-17, An Act to amend the Food and Drugs Act, Vanessa's law. I look forward to seeing that legislation made into law. These are important steps, which prove that individuals can change public policy, as I hope we will here.

By coincidence, the hon. member for Oakville has also taken a stand on the Lyme disease issue, having written a foreword to a Canadian book called Ending Denial: The Lyme Disease Epidemic.

In this non-partisan spirit, the official opposition, the New Democratic Party, was the first party to signal full support for my bill. The New Democratic Party health critic, the hon. member for Vancouver East, signalled some time ago that I could count on her party's support. It means a tremendous amount to me personally to have this support. It acknowledges the importance of this legislation.

The hon. member for Edmonton—Spruce Grove, the Minister of Health, has herself been very willing to work with me, which means the bill has the potential for success. We have sat down and worked over this bill, and there are some amendments that I would expect to see in committee. I do not regard them in any way as other than helpful. This bodes well for our ability to work together to make a difference on this issue.

What is this issue? Everyone in the Chamber is now familiar with the fact that Lyme disease is spreading. It is spread through a very specific bacteria that is carried by ticks, often blacklegged ticks or deer ticks, and it is now spreading to other species of ticks. The bacteria Borrelia burgdorferi is a bacteria that brings with it both a potential personal tragedy and a very troubling set of symptoms for diagnosis.

As I have said, this disease is spread through ticks. As we have seen, this disease can be delivered to other areas through the agency of birds. The range in which these ticks occurs across Canada has been spreading, and it is part of the increase in vector-borne diseases that are anticipated in relation to global warming and the climate crisis.

We know there are more cases of the disease. It was shocking to many, when in the summer of 2013, the Centers for Disease Control and Prevention, in Atlanta, Georgia, issued a revised estimate of Lyme disease in the United States. Its new estimate increased the prevalence of Lyme disease ten-fold, reporting that the previous year's 30,000 cases were probably 300,000. This is a timely reminder to us in Canada that the incidence of Lyme disease is spreading.

To the credit of Health Canada, since 2009 Lyme disease has been a reportable illness in Canada. There is no question that we know it exists in Canada, and health professionals have a mandatory duty to report a diagnosis of Lyme disease. We are also aware that it is under-reported. Currently any medical practitioner who diagnosis Lyme disease has a responsibility to inform the provincial health authorities, who in turn report this to the Public Health Agency of Canada. At this point, only 310 cases have been reported across Canada.

I am sure my colleagues on all sides of the House know that the number of cases is somewhat low, just in terms of our own anecdotal experience of constituents who have Lyme disease, and from the number of petitions we have received in this place from people urging us to find a solution and urging better treatment and a cure. We cannot estimate exactly how low that is, but as in the United States, I think we will find that as we increase awareness we will have a clearer understanding of the incidence of the disease.

Let me review quickly what the bill would do. This is a bill to deal with the threat of Lyme disease, but it does it in a couple of different ways. The bill's goals are to create a national surveillance system dealing with the problem that I just mentioned; we do not always have good information on exactly where the ticks are spreading and how prevalent they are.

The other area that is important is to get a handle on better awareness, perhaps national standards, or at least a sharing of best practices, to understand the challenges of diagnosis and treatment.

The bill calls for:

3.(b) the establishment of guidelines regarding the prevention, identification, treatment and management of Lyme disease, including a recommended national standard of care that reflects current best practices for the treatment of Lyme disease;

It also calls on the Minister of Health, working with others, to create a national program of educational materials to increase public awareness, but also to assist medical professionals. The process by which this would take place is that once the bill has come into force, there would be a mandatory obligation on the minister of health to convene, within six months, a national conference of provincial and territorial ministers of health, as well as the stakeholders, who are described in the bill as representatives of the medical community and patient groups, for the purpose of developing this national framework.

I am very heartened that at this relatively early stage in the consideration of Bill C-442, it has already received the support of important elements within the medical community. I want to cite particularly, and to thank, Eric Mang, director, health policy and government relations for the College of Family Physicians of Canada, who wrote in the fall of 2013 that they support the bill. He stated:

[The College of Family Physicians of Canada] supports further studying the economic and health impacts of Lyme Disease to ensure that Canadian physicians have the necessary tools and knowledge at their disposal. Guidelines produced as part of the strategy should include the input of family physicians and be available to all primary health care providers.

Even more recently, on February 27, 2014, I was thrilled to receive a letter from the Canadian Medical Association and its president, Dr. Louis Hugo Francescutti. Coming from the medical community, it is important that I read some of this letter into the record at second reading debate. He wrote the following:

Diagnosis of Lyme disease can be difficult because signs and symptoms can be non-specific and found in other conditions. If Lyme disease is not recognized during the early stages, patients may suffer seriously debilitating disease that may be more difficult to treat. Given the increasing incidence of Lyme disease in Canada, continuing education for health care and public health professionals and a national standard of care can improve identification, treatment and management of this disease. Greater awareness of where ticks are endemic in Canada, as well as information on the disease and prevention measures, can help Canadians protect themselves from infection. A national Lyme disease strategy that includes representation from the federal, provincial and territorial governments, the medical and patient communities can address concerns around research, surveillance, diagnosis, treatment and management of the disease. In addition, public health prevention measures will advance our current knowledge base, and improve the care and treatment of those suffering from Lyme disease.

With the support of those two important associations of medical professionals, the Canadian Medical Association and the College of Family Physicians of Canada, I am encouraged to know that we can work together as members of Parliament from all parties in this place. The approach set out in the bill for a national conference urges federal and provincial jurisdictional responsibility in the health community; the medical community, the doctors, health care professionals, nurses, people who deal with trying to sort out a diagnosis for Lyme disease when it is not always easy; and the patient communities, people who have advocated, who have cried out for help, people for whom this bill represents the first ray of light in what, for many, has been years of suffering. I am enormously encouraged by the support from the medical community.

I want to now turn to the support from the patient community. I would never have thought to put forward a private member's bill on Lyme disease had I not encountered so many Canadians who are suffering from the disease. My first friend who told me she had Lyme disease was Brenda Sterling, of Pictou County, Nova Scotia. From her wheelchair, she told me that she had been bitten by a tick and now she was virtually disabled. I was shocked. I did not know Lyme disease could be so serious when I first met Brenda, but she educated me about it.

Then when I moved to Saanich—Gulf Islands and was living in Sidney, I kept meeting people who were experiencing Lyme disease, some of them kids. It is heartbreaking to know a brilliant, beautiful young woman, Nicole Bottles, who is in a wheelchair and not able to go school. It is not because the wheelchair is a difficulty, but because the Lyme disease, as she says, muddles her brain from time to time. She has trouble concentrating and she has not been able to keep up with her schooling. However, she and her mother, Chris Powell, whom I think have met many of the people in this chamber today, have come to Ottawa and advocated for Bill C-442. They see it as a way to get to better levels of awareness.

I am so grateful to James, Michael, and other young constituents, like Eric, and his family. When I think about why I chose this bill, it had a lot to do with Eric and his family. His father-in-law was a strong supporter of mine, and I wondered how I could ever thank him. I am thankful to Fraser, among many people, for my bringing forward a bill that could try to make a difference in thousands of lives.

As we work toward this bill, let us keep a couple of hopeful things in mind. One is that we should never fear the outdoors. Some people have come to me since this bill was tabled saying, “For Heaven's sake, be careful that we don't create fear of going outside”. I want to emphasize that is not my intention.

I subscribe to the view of some who have described nature deficit disorder as a real threat to our kids. They need to get out and engage with wilderness. They need to be in nature. It increases learning abilities, capabilities, and emotional maturity. It is great for kids to spend time outdoors.

We have become used to the education challenge of a thinning ozone layer, which due to the Montreal protocol is reversing the thinning process. Over the years we have become used to asking what the UV rating is, wearing long-sleeved shirts, remembering to use sunscreen, and wearing a broad-rimmed hat, something that did not occur when I was a kid. These are common-sense prevention measures.

We need common sense to be a part of our daily routine. When our kids go out to play, we need to say, “Tuck your pant legs into your socks”, and when they come in from playing outdoors, to say, “Let me give you a quick check to make sure you haven't picked up a tick”. Those kinds of things are common-sense prevention measures.

The good news when facing Lyme disease is that it is preventable. That is why a federal framework makes so much sense. If we are aware of the disease, and watchful, we will not get it in the first place. However, if we do get it and diagnosis is speedy and correct, the treatment works. The treatment need not take long, and one can recover to a complete state of health and well-being.

Lastly, let us shine a light of hope for those dealing with the challenge of continuing debilitating symptoms. With a real focus and continued research, we can find treatment measures that will work for the entire Lyme patient community.

I am indebted to all of the members who have come here this morning for second reading, and thankful for their support. With their help, this bill will become law.

[Bryan Hayes, Conservative, Sault Ste. Marie, ON]

Mr. Speaker, I thank the member for Saanich—Gulf Islands for bringing forward this important piece of legislation on behalf of one of my constituents, who suffered for the longest time in terms of finding a diagnosis and then treatment. She was not able to find appropriate treatment in Canada, and I believe she went to Mexico three times for treatment.

In terms of best practices and treatment, is the intent to look worldwide and go outside of Canada and the United States, to search for the best treatment possible?

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I want to make a point clearly and this gives me a good opportunity. I am not a medical doctor. A few of us in the House are, but for the most part, I want to make sure that the medical diagnosis and research is left to medical experts, the ministers of health provincially, federally, and territorially.

I would think it makes sense to do what my hon. friend suggests. My constituents have gone to the U.S. and to Mexico for treatment. I was interviewed this morning by Kamloops CBC, where a family is trying to raise money for some treatment in Florida. I do not know what it is.

It is important that as members of Parliament we set up a framework to allow the research to extend to wherever the answers will be found, but we should not prejudge that. We should make it possible for medical professionals to seek out best practices.

I think a lot of those may be in Canada. We just need to share across provincial and territorial boundaries, and perhaps international ones as well.

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, I congratulate and thank my friend and neighbour from Saanich—Gulf Islands for her excellent presentation and for her hard work on the bill.

During her speech, she alluded to certain amendments that might be brought forward at committee stage, and I wonder if she could advise the House on the kind of amendments she would consider acceptable.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, it is helpful to perhaps give a prelude. I do not assume anything. I am keeping my fingers and toes crossed that the bill gets through second reading and to committee.

The Minister of Health has been very forthcoming in sharing with me some of the things she thinks would make the bill easier, from her point of view, and obviously I want to do everything possible to be reasonable and bend over backwards to make sure we can accept any amendments.

The kinds of things suggested are really sensible. I do not want the bill to create, for instance, any federal or provincial jurisdictional conflict. It has been suggested that we change the terms “standard of care” to “best practices” and “national strategy” to “federal framework”, and to give the Minister of Health, who in the current version of the bill is given six months to hold a conference from when the bill enters into force, to perhaps make that longer, to ensure that federal-provincial processes are respected. It could go to perhaps 12 months.

None of those things strikes me as anything other than helpful, and I certainly look forward to getting the bill to committee so that those amendments can be made.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, I pick up on the need for having that national strategy, as individual provinces, some more than others quite possibly, look at what can be done with Lyme disease.

Would the member comment on why it is so important that there be a national strategy? This way we could better serve all Canadians.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I think the reasons are clear in terms of the context. Some hon. colleagues have asked me why the federal government should be involved in this. Partly, unlike other diseases, this one is preventable. Better knowledge and sharing of best practices can allow Canadians, wherever they go across this country, to know—as with the metaphor of UV radiation and skin cancer—are we in a part of the country where ticks bearing this bacteria are endemic? Are we in a place where we should perhaps be more vigilant than usual?

The more we share across provincial boundaries, best practices, the more the medical community is able to benefit from what some doctors are doing in one part of Canada, which is quite different from what is happening elsewhere. Sharing best practices as a country will make sure that all Canadians, wherever they live, are better protected from this terrible disease.

[Gerald Keddy, Conservative, Parliamentary Secretary to the Minister of National Revenue and for the Atlantic Canada Opportunities Agency]

Mr. Speaker, it is certainly an honour for me to rise today to participate in this debate on Bill C-442, an act respecting a National Lyme Disease Strategy. I would like to begin by commending the member for Saanich—Gulf Islands for her stewardship of this important bill, and I would like to acknowledge its support by many members in the House.

The hon. member mentioned in her comments that many of us, myself included, live in areas where the blacklegged tick, or deer tick, is endemic. In addition, many of us, myself included, have constituents who have contracted Lyme disease at some point.

This is an endemic disease. It is a Canada-wide disease, and it is a disease that is spreading. For those reasons, we need a national strategy. The support for this bill underscores the need to work together and to address this emerging infectious disease in order to minimize the risk for Canadians.

Across the country, the number of reported cases of Lyme disease has increased significantly in the last decade. In fact, the actual number of cases in Canada is estimated to be up to three times higher than reported because many Canadians may not seek a full diagnosis and, quite frankly, many medical professionals do not know how to diagnose Lyme disease.

To underscore that point, as the hon. member would know, Lyme disease was first reported in Lyme, Connecticut, in 1975 or 1974. Here we are, 39 years later, with Lyme disease endemic throughout New England and now it has spread into Canada, following the white-tailed deer, of course, and we still do not have a national strategy for Lyme disease. That underscores the need for the important discussion we are having in the House of Commons today.

This has led to a growing recognition among governments, health practitioners, and stakeholders that work needs to be done to address this emerging infectious disease. Support for this bill also highlights the need to better leverage efforts at the federal level and across jurisdictions in Lyme disease surveillance and research.

Our government has already established improved surveillance specifically aimed at Lyme disease, and welcomes the sponsor's efforts to bring additional attention to this important issue.

The proposed bill highlights the need for continued action by governments, stakeholders, and the public health and medical communities to improve the understanding and awareness of risk factors, prevention, and treatment options. The objectives of this bill are laudable, and in fact align with the many activities already being undertaken by our government. Canadians should be reassured that the government has not been standing still.

We are already making significant progress under the leadership of the Public Health Agency of Canada. We are working with provincial and territorial health authorities and other partners in informing Canadians of the health risks from contracting Lyme disease. We also continue to help protect Canadians against Lyme disease through improved surveillance, by conducting research, by providing factual and evidence-based information to Canadians, and by providing support for laboratory diagnosis. Since 2006, our government has invested $4.6 million through the Canadian Institutes of Health Research to specifically fund research on Lyme disease and to disseminate the latest findings and knowledge to the scientific community.

These efforts are a central component of the Public Health Agency of Canada's approach to infectious diseases in Canada. More specifically, our approach to Lyme disease takes important action to reduce the disease's impact.

We do this by enhancing surveillance, prevention, and control; research and diagnosis; and engagement, education, and awareness. These three areas are consistent with the key elements of the bill, and our approach is already delivering results. However, as mentioned before, we are also prepared to do more, and in a collaborative fashion, to further address this emerging infectious disease.

That is why I want to signal to the House today that the government supports the intent of Bill C-442 and that we will be proposing practical amendments to ensure that the vision and values expressed in the bill can be realized and provide maximum benefit to the Canadian people.

The bill addresses an important issue, but it needs to be refined to remain consistent with the jurisdictional roles and accountabilities of Canada's federal system of government. In keeping with the spirit of the bill, we must be mindful of our federal role and respect jurisdictional accountabilities.

As we know, the provision of health care services in Canada falls under provincial and territorial jurisdiction. It is the provinces and territories that establish and monitor standards of care for health providers. It is also the purview of relevant medical colleges to define clinical care guidelines.

It is not the federal role to tell medical professionals how to practise. The proper role for the federal government in this area is to ensure that best practices are being shared across all jurisdictions, so that Canadians can be reassured that treatments are guided by the best scientific evidence.

In a similar vein, dictating to provinces and territories how and where to allocate their spending is contrary to our government's approach to fiscal federalism. However, it is within our federal role to facilitate collaboration across jurisdictions and with stakeholders to monitor and address the challenges posed by Lyme disease.

We are doing precisely that through our involvement in the Pan-Canadian Public Health Network and our collaborative work with stakeholders such as the College of Family Physicians of Canada and patient advocacy groups.

For example, the Public Health Agency of Canada is already working with the College of Family Physicians of Canada to engage health professionals on Lyme disease by increasing awareness among health care providers to enable them to recognize, diagnose, and treat the disease in its early stages.

Suffice it to say, while we concur with the bill's goals and objectives, it would need to be amended to reflect these jurisdictional realities, which is something that the hon. member has already mentioned she is supportive of.

This government is looking forward to working with the member for Saanich—Gulf Islands and will propose amendments in these areas to ensure that the bill is consistent with the provinces' and territories' primary role in delivering health care.

Early on in my speech, I mentioned that 39 years ago, Lyme disease was first diagnosed in Lyme, Connecticut. It took 39 years to get to this stage.

I have heard some members in this place—as the hon. member for Saanich—Gulf Islands has already alluded—question whether they would support this piece of proposed legislation. Some members say that Lyme disease is not prevalent in their area or that it is not endemic in their area.

I would suggest to these members that they had better take a look at whether they have white-tailed deer in their area. The blacklegged tick, better known in my part of the world as the deer tick, came to North America with the white-tailed deer. It has spread very successfully in most jurisdictions of North America.

As deer become more urban, or perhaps as humans become more rural, more white-tailed deer are moving into what were once rural areas, which are now urban areas. Therefore, this disease is only going to get worse, and it has been wildly underreported. There are a number of cases we are still trying to diagnose that I suspect will end up being Lyme disease or some variant of Lyme disease.

In closing, I commend the hon. member for Saanich—Gulf Islands for her very important and extremely timely work on this file. I have a number of constituents in South Shore—St. Margaret's in Nova Scotia who are watching this file as it proceeds forward. These folks either have contracted Lyme disease themselves or have family members who have contracted Lyme disease.

This is a terrible, insidious disease that is very difficult to diagnose. Therefore, this is very timely legislation.

[Murray Rankin, NDP, Victoria, BC]

Mr. Speaker, I am very pleased to rise and speak to Bill C-442, an act respecting a national Lyme disease strategy at this second reading stage. Again, I would like to acknowledge the work of my colleague from Saanich—Gulf Islands in bringing forward this very important initiative.

I want to say from the very outset that the official opposition will be voting in favour of this bill.

I want to acknowledge as well the pioneering work of former MP Judy Wasylycia-Leis who, well over five years ago, urged the health minister to implement such a strategy. Our NDP health critic from Vancouver East has also written to the Minister of Health about this issue and pushed very hard to establish a national strategy to diagnose, treat, and do better surveillance for Lyme disease in response to the growing threat of infection from coast to coast. Both she and I have seconded this important bill. Receiving early and appropriate treatment would improve the quality of life for thousands of Canadians and their families.

Lyme disease is one of the fastest growing infectious diseases in North America. I have heard first-hand about its devastating effect from a constituent, Nicole Bottles, who is a 20-year-old sufferer of Lyme disease. She is now in a wheelchair and met with me in Ottawa to advocate for this national strategy bill.

Early treatment of Lyme disease reduces the severity and duration of the illness. Experts agree that more accurate testing and earlier treatment of Lyme disease would reduce the health care costs associated with a lengthy illness and the more severe side effects, particularly for women, who suffer longer-lasting effects when their Lyme disease goes untreated. As members know, Lyme disease is caused by a specific bacterium spread through tick bites. It is one of the most under-diagnosed diseases in Canada. However, Lyme disease symptoms can range from a localized rash to fatigue to very serious central nervous system disorders that can lead to paralysis.

Let me begin by outlining the nature of the disease; then I will talk about what Bill C-442 is intended to do to address the problem.

Last month, the newspaper in my community, the Victoria Times Colonist, reported that a Vancouver Island hawk became the first raptor to join the list of species believed to spread Lyme disease. Research scientist John Scott found a Cooper's hawk with 22 ticks on it, 4 of which were infected with the bacterium that causes Lyme disease. It is the first raptor or bird of prey known to host this bacterium. The Cooper's hawk was found on the doorstep of a house in Oak Bay, part of my constituency. It flew into a window. Then it was delivered to the wild animal rehabilitation centre near Victoria, where it was examined.

Five of the six species of ticks that live on Vancouver Island are apparently involved in the transmission of Lyme disease. Other known reservoir hosts include songbirds, deer, mice, and rabbits. I would agree with my hon. friend opposite from South Shore—St. Margaret's that deer have become an increasing part of the problem, and in communities such as Oak Bay, the rapid increase in the deer population can only cause additional concern about the spread of this devastating disease, because the ticks feed on the blood of animals and humans and pass on Lyme disease. The ticks feed on species that include mice, birds, and the like; then they carry the bacterium and bite humans, and the disease cycle begins.

Ticks are most common during the warmer months, so Canadians who live in areas of our country with mild winter temperatures and minimal snowfall, such as southern Vancouver Island, have an increased risk of coming into contact with ticks. However, as Bill C-442 notes in its preamble, climate change is one of the factors causing more and more regions of Canada to be at risk. As we experience more warmer weather ahead of us, that would only increase the tick distribution across the country, as scientists have predicted.

By 2009, Canadian physicians were required to report on cases of Lyme disease to their provincial health registries. However, according to CBC News last year, national statistics are still unavailable at this time.

Recently, as the hon. member for Saanich—Gulf Islands mentioned, the U.S. Centers for Disease Control and Prevention estimated the number of people in the United States affected by Lyme disease was around 300,000, but that figure is 10 times higher than what is reported to that agency. In the province of New Brunswick in 2009, there were 128 confirmed cases of Lyme disease, but by 2011, that number had doubled to 258.

If Lyme disease is treated at early stages with antibiotics and the tick is removed, the severe neurological symptoms that often occur can be avoided. I am told that in some states in the United States, such as Massachusetts, it is relatively routine for the tick to be removed and antibiotics administered at that early stage. However, there seems to be a different level of awareness in Canada; hence, the need for the strategy before us.

Unfortunately, there does not seem to be any standardized testing for Lyme disease in Canada, so Lyme disease advocates and health practitioners say the different types of blood tests performed to identify Lyme disease currently yield inaccurate results. What does that mean? It means that patients who in fact have Lyme disease are often not diagnosed or are misdiagnosed with such illnesses as multiple sclerosis or chronic fatigue syndrome. They do not receive the appropriate treatment, thereby exacerbating the symptoms. I have spoken with some patients from Victoria who say they have had to travel to other countries, as the member opposite for Sault Ste. Marie has also acknowledged, possibly because the treatment in Canada ranges so dramatically and is often inadequate.

What would Bill C-442 do, then? First, it would track the incidence rates, create educational materials to raise awareness about Lyme disease, and establish testing and treatment guidelines, as well as track the related economic impacts of Lyme disease. Second, Bill C-442 would support research and implementation of better and more reliable diagnostic testing, as well as increased education and awareness among physicians. In short, the bill would create a coordinated strategy, which is long overdue.

Canadians deserve to get adequate testing and treatment for this disease. The federal government is responsible for improving the surveillance of Lyme disease, as well as establishing best practices so that the provinces can better understand the disease and adopt evidence-based measures to improve outcomes.

The Canadian Lyme Disease Foundation, or CanLyme, is in full support of Bill C-442. President Wilson stated, “This bill responds to the failure of existing guidelines to reliably detect and treat Lyme disease”.

As the member for Saanich—Gulf Islands already noted, the College of Family Physicians of Canada has also supported Bill C-442. It stated, “The CFPC supports further studying the economic and health impacts of Lyme Disease to ensure that Canadian physicians have the necessary tools and knowledge at their disposal”.

I regret that past governments have failed to take the appropriate leadership role on a range of important health issues, including the kind of coordination and funding that are necessary for health innovations, testing, and treatment. It was only in 2009 that we began to track Lyme disease, and some have argued in my office that there has been a failure to heed the pleas to advance testing and treatment options in this country. Therefore, this is an issue where the federal government must show leadership in health care and work to better protect and support the health of Canadians.

This is far from a partisan issue. It does not help at all to talk about past governments. We want to stand firm with the hon. member for Saanich—Gulf Islands and all members of the House to address this problem. The time to act is now. Sufferers from Lyme disease are looking to the government for leadership. The official opposition wants to be part of that solution. It is time to get on with it. New Democrats will be voting in support of this bill.

[Kevin Lamoureux, Liberal, Winnipeg North, MB]

Mr. Speaker, it is with pleasure that I rise today to support Bill C-442. On behalf of the Liberal caucus, I would indicate that we do support the bill and want to see it ultimately passed, going through our committee process and, obviously, third reading.

I was encouraged to hear from the leader of the Green Party that she is open to having some possible amendments that would not change the intent of the bill but, quite possibly, make it a bit more practical, in terms of its implementation.

Lyme disease is a very serious issue, as it has been said at length in the last 45 minutes. I thought I would emphasize it from a different perspective, from more of a personal perspective, in terms of what I believe is likely the most important issue facing this particular disease; that is, the whole sense of public awareness.

There are different regions in Canada, some more affected by Lyme disease than others. In Manitoba, it is a very serious disease. Many people are aware that in Manitoba we have beautiful, wonderful summers. Many of my friends have cottages out in rural Manitoba. There are all sorts of youth camps in the province. In some regions of the province of Manitoba—in particular, in the southeast—there is a higher risk factor of Lyme disease, and we need to ensure that there is a higher sense of public awareness.

Over the last three or four years, maybe, I have found that there seems to be a higher sense of a public awareness, but even today, I do not believe enough is being done in terms of promotional educational material and the government taking a proactive approach to ensuring there is a high level of education with respect to this particular disease.

That is one of the aspects of the bill that I do support in its entirety: the fact that we need to recognize that and incorporate it. I am glad it is actually in the legislation itself.

I have gone through all the different trails, for example, at Pelican Lake, which is in the southeast part of Manitoba. I have spent many days with my daughter, in particular. When we get back to the cabin after a half day of going through the trails, we might have a dozen or so ticks on us. Even though we have taken the precaution to wear long-sleeved tops and tuck our pant legs into our socks and put on some form of repellants, somehow the ticks have this ability to cling onto us. It does not take much.

We make sure we do what we can to get rid of the ticks, if we see them on us.

However, what amazes me, when I have had the opportunity to talk to people about Lyme disease, is the number of people who do not know what Lyme disease is. They know what a wood tick is and have often had them on their body, but they do not know what Lyme disease is. I find that to be actually quite tragic. These are individuals who I thought would have known: some of the more regular cottage-goers.

I made reference to youth camps. We have young people who participate in camps throughout Canada. I made comments with respect to southeastern Manitoba. We have had cases of Lyme disease identified in most provinces. Every year we will have literally tens of thousands of children participating in outdoor activities, in summer camps, and so forth.

As the leader of the Green Party pointed out, we want to encourage our young people, and all people, to appreciate and enjoy the outdoors, but it is very important that we recognize the advantages of being proactive in terms of material on this particular disease, because of the debilitating impact on someone acquiring Lyme disease.

Most would say that it takes two or three days before the symptoms are seen. However, it can often take a week or so. It has appeared months if not a couple of years after an original infection from a tick.

Symptoms are fatigue, fever, headaches, and a bull's-eye rash. People need to be aware of and look for these symptoms.

In terms of the consultation process, a priority is to come up with a program that has educational and promotional components.

The role of the federal government would be to work with the provinces and territories. That needs to be expanded to include the medical professions as well as the other stakeholders, such as school boards, non-profit groups, and groups that promote the outdoors. These include outdoors groups, cottagers, and ATV and jogging clubs. We need to heighten awareness of this disease.

I would like to think that we would take a holistic approach in developing an overall strategy. I recognize that the federal government has a strong role to play in terms of best practices. That is where we can complement provincial and territorial jurisdictions.

We need to make sure that there are resources. If we can be more proactive on the front end, we will dramatically impact the spread of this disease. What we have realized is that the number of reports of Lyme disease is on the rise.

Bill C-442 proposes that the federal government convene a conference with the provincial and territorial health ministers and different stakeholders and that it establish a national medical surveillance program to use data collected by the Public Health Agency. The bill also calls for a report on the strategy, to be tabled here in Parliament. The strategy would be reviewed for effectiveness after five years.

I believe this is a bill worth supporting. We in the Liberal caucus support it and anticipate that it is only a question of time before it passes.

[David Tilson, Conservative, Dufferin—Caledon, ON]

Mr. Speaker, I am pleased to participate in today's debate on Bill C-442, An Act respecting a National Lyme Disease Strategy. I would like to start by stating my own personal support for Bill C-442. I am pleased to see that most, if not all, government members will be showing such support as well.

I am also pleased with how the federal government is working with the provinces, territories, and stakeholders to address Lyme disease. The bill would be a sound complement to these efforts.

As members of the House are aware, Lyme disease is a rapidly emerging infectious disease in North America and in Europe. It is transmitted to humans from the bite of infected blacklegged ticks. Over the past few years, I have met with a number of constituents from my riding of Dufferin—Caledon who suffer from Lyme disease and with the family members and friends of sufferers. They have related to me the symptoms they live with and the difficulties they have faced within the medical system.

In October 2012, I met with a constituent of my riding, whose name I will not use for privacy reasons, who has been suffering with Lyme disease for seven years. She informed me of the difficulty in diagnosing the disease, which is similar to multiple sclerosis. She also informed me of the type of treatment she has been receiving and gave me some detail about what it was like to live with this disease.

This constituent is quite passionate about raising awareness of this issue. She organized signatures for a petition, which I had the honour of tabling in the House. The petition called for the government to increase its efforts on behalf of those suffering with Lyme disease.

That brings me to the bill before us today. Numerous residents of Dufferin—Caledon have written to me regarding Bill C-442. I am honoured to speak to the bill.

The number of reported cases of Lyme disease in Canada increased ninefold between 2003 to 2012 to over 300 cases annually. One of our problems is that the actual number of cases of Lyme disease is estimated to be three times higher than the number of cases that are actually reported. Even more troubling, based on current trends, the Public Health Agency of Canada estimates that these numbers will continue to rise.

In the majority of cases, Lyme disease symptoms may include fever, headache, and fatigue. Fortunately, if diagnosed early, Lyme disease can be treated quickly and effectively with antibiotics. In cases of late diagnosis, where the disease has spread through the body, the burden of illness and the cost to the health system increase exponentially. Suffice it to say, if left undiagnosed, the impacts can be devastating.

Let me put in perspective why we need to make progress in raising awareness of the challenges Lyme disease poses and the importance of early diagnosis and treatment. This applies as much to the public at large as it does to health professionals.

If Canada were to indeed be managing the increased rate of Lyme disease, the difference in the costs associated with early versus late diagnosis would be startling. The Public Health Agency estimates that the potential cost of early diagnosis in 2020 would be just over $8 million annually. However, for late diagnosis, that figure could rise to over $338 million.

Fortunately, our government has made significant research investments in areas related to Lyme disease. Indeed, since 2006, we have invested over $4.5 million. We have established improved surveillance specifically aimed at Lyme disease so that action can be taken quickly and effectively. We are also providing federal leadership, building consensus, mobilizing partnerships, and promoting education and awareness.

Research has shown that climate change is bringing Lyme-disease-carrying ticks further into Canada. Understanding and tracking their movement is an important part of any future strategy for combating Lyme disease.

Supporting research to generate new insights into how Lyme disease is evolving, why its impacts vary so widely, and how it can be treated is central to our efforts. That is why we are committed to supporting research on the range of strains of tick-borne pathogens and their geographic locations and on the epidemiology and intervention of the disease in Canada. This will help us better forecast how Lyme disease is spreading and how its impacts can be contained.

However, the federal government cannot and should not act alone. With Lyme disease now a national reportable disease, it should also come as no surprise that we have been working closely with the provinces and territories. Early measures include exploring how we can work together in communicating the risks of Lyme disease to the public and the medical professions.

We are also reviewing current Lyme disease guidelines to ensure that they are based on the best evidence available. This will help us educate Canadians in identifying and protecting themselves from Lyme disease.

These collaborative efforts do not occur in a vacuum. This is an integral part of the Public Health Agency of Canada's approach to managing infectious diseases. The agency's key areas of action are surveillance, prevention and control, research and diagnosis, and engagement, education and awareness.

Let me summarize just a few of the ways that work in these areas is providing real results for Canadians struggling with Lyme disease and their families.

The Public Health Agency is conducting surveillance of Lyme disease in Canada and is developing strategies to encourage preventive behaviour. It is investing in new laboratory methods to improve our surveillance of the tick that causes Lyme disease. It is undertaking research on new strains and pathogens of tick-borne diseases, and it is updating public health guidelines on Lyme disease. The agency is also working to develop new approaches to better educate both health care providers and the general public, especially those at risk of infection, about Lyme disease. Together these efforts will equip all stakeholders to better respond to Lyme disease.

Our government's current leadership in this area, coupled with the positive principle of the bill before us today, will serve to focus on protecting the health and safety of Canadians. It will recognize the need for action and leadership to mitigate the impact of Lyme disease. It will drive the imperative for evidence-based decision-making and the sharing of best practices. It will acknowledge the importance of collaboration to raise awareness of the disease, how to avoid it, and how to diagnose and treat it. It will also disseminate data on the real impact Lyme disease has already had on too many Canadian families.

That is why, as I said at the outset, I am supportive of the principle of the bill and look forward to reviewing the work undertaken by the health committee. I encourage all members of the House to support the bill.

[The Acting Speaker, Conservative, Barry Devolin]

The time provided for the consideration of private member's business has now expired, and the order is dropped to the bottom of the order of precedence on the order paper.

The House resumed from March 3 consideration of the motion that Bill C-442, An Act respecting a National Lyme Disease Strategy, be read the second time and referred to a committee.

[Craig Scott, NDP, Toronto—Danforth, ON]

Mr. Speaker, it is my pleasure to rise to speak to Bill C-442, An Act respecting a National Lyme Disease Strategy, which has been tabled by my colleague from Saanich—Gulf Islands and seconded by my colleague from Vancouver East.

It is worthwhile noting that the House has looked at the question of Lyme disease in incremental steps since at least 2008. At that time, Judy Wasylycia-Leis, who is a former member of Parliament from Winnipeg North, called for a national strategy and by 2009 she was submitting order paper questions to find out more from the government about what it was doing, or perhaps better put, not doing.

As the successor to Jack Layton in Toronto—Danforth, it was of some interest to have discovered in correspondence provided to me by a constituent that on January 17, 2008, Mr. Layton had written to the Conservative minister of health at the time outlining the life circumstances of David Leggett, one of my constituents, who I rely on heavily in terms of his counsel on this issue.

To cut a long story short, Mr. Layton indicated to the minister that he had issued an information request under the Access to Information Act requesting results on the proficiency tests of a federal laboratory with respect to the ability to identify Lyme indicators in blood. The whole point was that the ability to do so was the key to early detection and therefore to effective treatment. There is this wonderful line in the letter, “The request for information was denied on the basis of national security. Neither Mr. Leggett nor I can understand the basis for this response”.

Although I am not here to explain or to talk further about why such a bizarre response to an information request on Lyme disease would have been received, it is rather indicative of the climate that patients, advocates and supporters have faced for a good number of years. There seems to be this bunker mentality in various quarters, and maybe as far back as 2008, that was shared by the Conservative government. I realize that things are moving ahead and that the Public Health Agency of Canada can be counted on more as an ally in this struggle. I hope that will lead to all members of the House supporting the bill from my colleague from Saanich—Gulf Islands.

Time is marching on. The Centers for Disease Control and Prevention in the United States has upped its estimate using a whole set of methods to approximately 300,000 Americans a year being diagnosed with Lyme disease. This is a 2013 analysis. From that, apart from the high incidence, it concludes that the CDC and other researchers must continue to identify novel methods to kill ticks and prevent illness in people. Lyle Petersen of the CDC said, “We need to move to a broader approach to tick reduction, involving entire communities, to combat this public health problem”. That is all well and good.

It is important to note the preventative angle. However, it is also, through my interactions with constituents, the whole question of diagnosis. Once people are unlucky enough to get infected, early diagnosis leads to them, potentially so early, to actually being able to prevent any effects, but within a short period of time that will be impossible. Therefore, to receive effective treatment has to be as much at the top of our agenda as the broader prevention.

It is also the case from recent research that it is very clear that the relevant ticks are moving north and that at some point in the next number of years the large majority of Canadians will live in high incidence zones. As I said, time is marching on.

My colleague from Saanich—Gulf Islands has devised something that is very much of a process, a process that will achieve something.

The first, or the central, pillar of the bill is the convening of a conference with all stakeholders within six months of the bill receiving royal assent to come up with a series of strategic outcomes, including, for example, establishing guidelines for prevention, diagnostics and treatment.

What I like in particular, and what I know people in the anti-Lyme disease advocacy community like most, about the strategy is how it makes sure to include the representatives of patient groups along with other experts in the medical community. From experience grows experience. I can attest to that in many conversations with David Leggett. From experience, he has insights that almost no member of the medical profession could hope to bring to the table.

I would like to share the stories of two of my constituents by way of bringing that home.

Alison says:

I am one of your constituents, living in the Danforth area, who has been battling Lyme for the last 7.5 years.

It took 5 years to receive a diagnosis, and now over 2 years of treatment to become more functionally stable. In 2011, I had to make the decision to go into massive medical debt in order to receive treatment - my Lyme literate doctor is located in New York.

I lost the ability to work 4 years ago. And, at this point, I'm quite scared about my future. I'm only 38. I've watched my 30s just rush by. I know that if I had received an earlier diagnosis, I wouldn't have had to experience such difficulty recovering.

I really don't want this to happen to any other Canadian. Lyme or no Lyme, all of us deserve medical care In our own country, and we deserve proper diagnostic tests and treatment. The current treatment guidelines for Lyme Disease in Canada, set by the College of Physicians, is an absolute joke. 30-days of antibiotic therapy is woefully inadequate: especially if a patient has been exposed to the Lyme bacteria for years. Personally, I didn't experience any noticeable, long-lasting symptom improvement until 13-months into antibiotic treatment.....

I recently calculated how much money I've had to spend on medical care in the last 7-years, and the total came to approximately $42,000. .... I want all MPs to know how incredibly expensive it is for Canadian Lyme patients to receive treatment. It never ceases to surprise me that I pay into a universal medical system (through taxes) that I have no access to. How crazy is that?

Donna also writes:

I am a Toronto-Danforth resident who knows only too well of the devastating (physically, emotionally and financially) impacts that lyme disease has on a person. I am also proof that there is a need for proper diagnosis and that extended treatment can be effective. I lost 5+ years of my life, and approximately $250,000 to the disease. I am (mostly) well again and have been very fortunate to have completed a successful return to work.

With respect to my (conservative) estimate of the cost, I don't want to mislead you...I was treated in the U.S., but those costs were only a small part of the actual costs.

I would end now by drawing on my constituent David Leggett whose insights I always welcome. He does say that when it comes to a strategy, something the NDP always emphasizes within the framework of collaborative federalism. In a recent note to me, he said:

Something to stress is the importance of working in lockstep with provincial government health ministries. To be truly effective, a national framework based on objective discovery, research, effective testing tools...training for doctors...and effective treatment regimes and timelines have to be set up and maintained.

Also, he says, echoing the other two constituents I just quoted:

—the fact that many lymies have had to rely on US laboratories and doctors for proper diagnosis and treatment. Without this support from beyond our borders (and mostly paid for out of pocket), the problem here would be borderline catastrophic.

The tabling of this bill is timely. It is needed. I congratulate and thank my colleague, the member for Saanich—Gulf Islands, for doing so. I fully intend to support it. I hope the strategy that does emerge from this, because I do have great hope that colleagues from across the way will also support it, will in fact make a big difference in what is likely to be a growing health issue for Canada in the years ahead.

[Terence Young, Conservative, Oakville, ON]

Mr. Speaker, I rise today to offer my thoughts on Bill C-442. The subject is a national Lyme disease strategy.

I am very pleased to second the adoption of this bill by Parliament to address the urgent needs of victims of this disease. I congratulate the member for Saanich—Gulf Islands for this initiative. I totally support the important principle of this bill and our government's efforts to amend the legislation at the health committee, of which I am a member.

As my colleagues on both sides of the House have recognized, Lyme disease is an emerging infectious disease in Canada. It is caused by a bacterium transmitted by ticks, now increasingly found in southern Canada, including in the greater Toronto area.

Like the member for Saanich—Gulf Islands, I have a friend who suffers from Lyme disease. In 2006, I received a call from my long-time friend, Janet Mitchell, a former Oakville town councillor, who had recently, after years of confusion and misdiagnosis, been diagnosed with Lyme disease.

Janet told me a hair-raising story. She had in previous years lost the feeling in and control of her lower extremities and had difficulty walking. She was naturally deeply engaged with and worried about what was happening. She had great trouble getting up and down steps and ended up using a walker to get around. She and her husband had to move to a condominium that had no steps. She had a fear that she would end up needing a wheelchair due to a disease that she had previously never even heard of.

Then Janet told me that she had heard that her condition could have come from the bite of an insect, which is very frightening. A deer tick had bitten Janet, and unlike most victims of such bites, she did not develop a visible target-like rash, so she had never noticed. This is not that rare. That tick had deposited a kind of poison in her bloodstream, bacteria that over time can hide in the human body and cause those symptoms. It finds places in our joints and elsewhere where antibiotics cannot easily reach. It is like a scary movie.

Reported Lyme disease cases in Canada increased from 30 in 2003 to over 300 in 2012, and these numbers are expected to rise even further as ticks responsible for Lyme disease move into Canada's most densely populated areas. These numbers will also rise as conditions thought to be something else or diagnosed to be something else are increasingly correctly diagnosed as Lyme disease. Indeed, based on current rates in the U.S., Canada is likely to experience a marked increase in Lyme disease cases in the coming 10 years. Some estimates report that by 2020, the economic cost of reported Lyme disease cases in Canada could reach $8 million annually, for cases diagnosed early, in medical costs alone.

Being from Oakville, in southern Ontario, I understand that it is my part of the country that will most likely see the sharpest spike in Lyme disease cases over the next decade. That is why it is so important to my constituents that we address this issue sooner rather than later, and it is why I thank Janet Mitchell for educating me about this nasty and insidious disease.

These unsettling statistics are some of the chief reasons I am supportive of this legislation before the House today and why I have also been pleased to hear of our government's work in addressing Lyme disease. In recent years, our government has committed to working with the provinces and territories to address these risks to Canadians. The Public Health Agency of Canada has undertaken enhanced stakeholder engagement, public and clinical education, enhanced surveillance, and research to improve diagnostic integrity, which is one of the key problems.

The Public Health Agency's work has focused on surveillance, prevention, and control as the first step. The second step is research and diagnosis, and the third step is engagement, education, and awareness. This work has demonstrated positive first steps to address an emerging yet serious disease, and Bill C-442 promises to further add to this drive. Additionally, our government has devoted funding dollars in support of Lyme disease research, primarily through the Canadian Institutes of Health Research. Indeed, since 2006, we have invested approximately $4.6 million in Lyme disease research.

Our government has also been diligently working in concert with the provinces and territories on surveillance and on prevention and control activities. Provinces and territories report Lyme disease as a national reportable disease, and these data are contributing to the Public Health Agency of Canada's ability to monitor and report on the disease's progress.

Of course, the reality is why I am supportive of our government's proposed amendments to the bill, as outlined in the above facts.

Janet Mitchell was originally told by her doctor that she had MS, a disease that is somewhat more common in Canada than in other countries. She was told, like many others across Canada, that she could not possibly have Lyme disease, because we do not have Lyme disease in Canada. That was the best diagnosis she could get at the time. I shudder to think of how frightening that false diagnosis would have been for her and other Canadians who may have been diagnosed in a similar way.

However, Janet studied her condition on her own. She had spent a lot of time camping and hiking. Absent a visible rash, she had all the described symptoms of Lyme disease she found on the Internet. Janet found a new doctor, who advised her that the only test done in Ontario was not that reliable. She paid to have her own blood sample sent to the U.S. for a test called IGeneX, otherwise referred to as Western Blot, which is far more reliable. That test told her that she had the Lyme spirochete in her bloodstream. She had Lyme disease.

The theory that we do not have Lyme disease in Canada was actually never really true. We just did not have very much of it. Yet our specialists misdiagnosed many Canadians with Lyme disease as having other conditions, preventing them from getting the treatment they needed, as if deer and birds do not cross international borders, because both carry the ticks.

If caught early, Lyme disease can be cured. The bacteria can be eliminated with common antibiotics like erythromycin. However, once the spirochetes invade the cells, it is difficult to kill them, requiring, in some cases, months of treatment with more powerful antibiotics. An early and accurate diagnosis is key.

It is clearly important to respond to emerging diseases such as Lyme, but as the federal government, we still maintain the responsibility to respect jurisdictional boundaries, especially with regard to health care.

I have been very pleased to see that our government has been delivering historic funding dollars in support of health care to be delivered by the provinces and territories. They are projected to reach $40 billion annually by the end of the decade, which is, of course, a new record.

Provinces and territories are responsible for health care delivery, and it is important that the bill reflect that reality. At the federal level, we do our part by supporting research and sharing best practices across jurisdictions. Indeed, we are the single largest investor in health research, with support of nearly $1 billion annually. These research dollars will deliver the resources necessary to support medical experts in developing the research necessary to adequately respond to new and emerging diseases.

As I mentioned earlier, I am a member of the Standing Committee on Health and very much look forward to further review of Bill C-442 when it is referred to us in the coming months.

In the course of the committee's work, I hope to hear from various stakeholder groups on the current and possible future impacts of Lyme disease, not the least of which will be medical experts on the subject. Their input will help contribute to the committee's understanding of this emerging disease and further inform our work going forward.

I would be pleased to work with the member for Saanich—Gulf Islands on the bill, which promises to further build upon the good work our government has been doing to address Lyme disease in Canada. I think her commitment to this evolving issue and her willingness to work with our government demonstrates a spirit of co-operation that will be important going forward.

As we look to proceed on the bill at its current stage, I anticipate a good and full discussion on its merits and on ways it can be further improved.

I thank my hon. colleagues from all parties for their attention, and I urge them to support Bill C-442 at this stage so that we may work to improve its recognition of jurisdictional responsibilities and the proper role the federal government plays in addressing emerging diseases.

I look forward to the health committee's proceedings on the bill and the testimony we will hear on the subject of Lyme disease.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Speaker, I too am pleased to rise in this House today to speak to Bill C-442, because like many other members in this House, I have constituents who have suffered from Lyme disease. Sadly, for many constituents, it has taken them months if not years to get an adequate diagnosis. In the meantime, their lives have been lives of misery, as they simply have not been correctly diagnosed or have not received the proper treatment.

Bill C-442 aims to track the incidence rates, create educational materials to raise awareness about Lyme disease, establish testing and treatment guidelines, and track the related economic impacts of Lyme disease. It would also support the research and implementation of better and more reliable diagnostic testing and increased education and awareness among physicians.

I want to turn for a moment to a Globe and Mail article that was in the paper on April 27. The headline was “Lyme disease on the rise in Canada, linked to ticks”. The subheading is, “This is the first in a series examining health repercussions for Canadians due to a changing climate. First up: Lyme disease”. In the article, the writer notes:

Most Canadians think of Lyme disease as a rare illness that afflicts hikers bitten by ticks in the deep woods. Infected individuals develop a bull's-eye rash and go on antibiotics for a few weeks to clear it up. Problem solved.

The trouble with this picture—promoted for years by Canadian health authorities—is that it does not begin to capture the true threat of Lyme disease, which in its chronic form can turn into a life sentence of debilitating joint pain and neurological problems. Disease-carrying ticks in Canada have increased tenfold in the past two decades, spread by migratory birds and nurtured by warming climates that allow them to thrive in our own backyards. While reported cases jumped 146 per cent between 2009 and 2012, advocates say that testing is inadequate and doctors lack awareness of Lyme, resulting in gross underreporting and under-diagnosis of this rapidly emerging infectious disease.

I can certainly say that on Vancouver Island, some of the response from the medical community has been that Lyme disease does not exist on Vancouver Island, so someone could not possibly have Lyme disease. Of course, when some of the constituents were able to get the testing, outside of Canada, sadly, spending thousands of dollars, it was demonstrated that they did in fact have Lyme disease and then needed to be on prolonged courses of antibiotics to deal with it.

Later in the article, it says:

Detecting Lyme disease is an evolving science, however. Recent studies have shown that different strains of Borrelia, the bacteria that causes Lyme, may target different organ systems, triggering a variety of immune responses. While the responses vary, one strain alone can affect skin, joints, the heart and nervous system.

Canadian health authorities recognize the need to detect different strains of the bacteria, the PHAC [the Public Health Agency of Canada] said in a statement, adding that Canadian labs are using “updated screening tests that are reactive to a much broader range of Borrelia strains”.

Mr. Wilson is with a not-for-profit organization that has been trying to raise awareness. The article continues:

But Wilson said that from what he has heard in the Lyme community, Canadian patients are still being offered the same old tests. The standard Western blot test detects only a lab strain of Borrelia and its close cousin.

The second test, known as the ELISA, isn't sensitive enough to distinguish Lyme from such illnesses as lupus or rheumatoid arthritis, according to Dr. Brian Fallon, director of the Lyme and Tick-Borne Diseases Research Center at Columbia University.

Both are known to have “significant limitations,” Fallon said.

Newer tests available at private U.S. labs can detect all strains and species of Borrelia bacteria. Although these tests have their own pitfalls, “they're really an improvement on the standard tests,” said Fallon, who saw no reason why they should not be widely used in Canada.

The article concluded by stating:

Unless Canada starts doing a better job at detecting Lyme disease..., “we're going to continue to have most people in the chronic category, because they're just not being picked up.”

This has a devastating effect. Certain people talk about the economy, but it has a devastating effect on people and their lives and on their families.

Part of the challenge with this is that, as I mentioned, in Canada, many patients report issues with the testing and treatment for Lyme disease. The different types of blood tests performed to identify Lyme disease often yield inaccurate results. This may mean that patients who in fact have Lyme disease are not diagnosed, or even more worrying, are misdiagnosed with multiple sclerosis or chronic fatigue syndrome and do not receive the appropriate treatment, exacerbating their symptoms. Some patients even have to travel to other countries to receive treatment, because it is inadequate in Canada.

The NDP believes that this bill would improve the treatment and outcome for Lyme disease sufferers. Canadians need a national strategy on Lyme disease to ensure that the testing and treatment options in Canada are improved. Therefore, we support this bill and believe it lays out a concise plan for educating Canadians about the disease and, more importantly, providing a better quality of life for Lyme disease sufferers.

To provide a bit of background on it, this disease is spread by tick bites. Ticks are small parasites that feed on the blood of animals and humans. They pass on Lyme disease when they feed on mice, squirrels, birds, or other animals who carry the bacterium and then bite humans.

Ticks are most common during the warmer months, from spring through to late autumn. Canadians who live in areas that have mild winter temperatures and minimal snowfall have an increased risk of coming into contact with ticks, which is a description of the climate on Vancouver Island. Climate change is one of the factors causing more regions to be at risk, with warmer weather increasing tick distribution across many parts of Canada.

I have been working on this file for a number of years. Back in 2010, I had written a letter to the then minister. We had a back and forth with a number of letters. I had written a follow-up letter asking for further clarification and action because part of the response from the government was that treatment and diagnosis is a provincial responsibility so there is really not much role for the government. I was trying to argue that of course there is a role for the federal government, and part of that role is around leadership. However, I reminded the minister that the federal government has a clear role to play in establishing the guidelines and that it is within this area that most action needs be taken.

I went on to remind the minister that the Canada Health Act's principle of reasonable access to health services without financial or other barriers is an important aspect of what Canadians expect in our publicly funded, publicly delivered health care system and that when we were seeing unequal access or seeing Canadians have to go out of the country in order to get adequate testing, that is absolutely a financial barrier.

I went on in the letter to say:

A number of studies have concluded that the tick vector is spreading rapidly in Canada, a process likely to be accelerated by climate change. Without current, up-to-date information about the geographical distribution of tick vector populations, doctors may falsely discount a possible Lyme disease diagnosis, and thus deny serological testing. In addition, the tick vector is also carried by migratory birds, and is therefore not isolated to any geographical region.

I quoted from an article published in the Canadian Medical Association Journal in 2009, entitled, “The emergence of Lyme disease in Canada”, stating:

...“effective enhanced surveillance involving federal and provincial agencies needs to be instigated and that clinician awareness of Lyme disease will be crucial in minimizing its impact”…as it is an emerging disease in Canada.

Further on I state:

Ultimately, Canadians are receiving inadequate care or no care at all when it comes to Lyme disease, forcing them to leave the country to seek medical attention. This is a direct denial of their rights. New national guidelines must be put in place to address this serious contravention of the Canada Health Act. Canadians should have confidence in their health care system.

Based on recent studies, the current Guidelines simply do not take into account that Lyme disease is emerging in Canada and that geography cannot be relied upon to diagnose Lyme disease. In addition, the two-tiered testing is fundamentally problematic as it excludes many patients who have Lyme disease from the more sensitive...testing...

In the response from the minister of September 15, 2011, it was interesting that the she indicated this in the letter:

Climate change is anticipated to accelerate the emergence of Lyme disease in Canada. Endemic Lyme disease risk occurs in much of southern British Columbia, but the vector here is less efficient, and risk is relatively low.

Therefore, even a couple of years ago the minister is indicating at that point that the risk was relatively low. I would argue that, because the government was not doing the kind of surveillance and follow-up that was required in order to determine the real incidence, people were simply being excluded.

There have been some changes. Although the government has moved to look at making this a nationally reportable disease in Canada, many people simply do not trust those numbers. Therefore, I will certainly be supporting Bill C-442. I want to commend the member for Saanich—Gulf Islands for bringing this matter forward. It is a very important matter for us in Nanaimo—Cowichan and the rest of Canada. I would encourage all members of this House to support this bill and let us get on with developing that national strategy that is so important for our constituents.

[Irwin Cotler, Liberal, Mount Royal, QC]

Mr. Speaker, I am pleased to rise to join in the debate on Bill C-442, an act respecting a national Lyme disease strategy. I commend my friend, the hon. member for Saanich—Gulf Islands for bringing forward this important bill that proposes the development of a national strategy in response to a growing issue of national concern.

I cannot overly stress how important this debate is, as well as its personal significance for me. As some members of this place may recall, a few years ago my daughter became ill. She had unexplained pains and symptoms of the kind and character that have been described by other members in the House in this debate that led her from doctor to doctor and diagnosis to diagnosis without any relief in sight.

It was a stressful and traumatic time for our entire family, a period and sense of both hopelessness and helplessness. Hopelessness on the one hand because it was unclear what the correct diagnosis was in the place of competing diagnoses, or the absence of any diagnosis at all, and helplessness because it was difficult to watch my daughter struggle and not be able to help in any way.

As is too often the case, one only learns the intricacies of a disease when one is confronted with it. That was my experience with Lyme. When my daughter's purported diagnosis came I read as much as I could about the disease and was shocked at the Canadian experience with the disease when compared to the American one. Indeed, at the time I learned that there was already a U.S. Congressional caucus discussing this issue, and that there had already been proposed legislation introduced south of the border, while the debate had hardly begun in this House at all.

While many statistics have been quoted in the debate here, I would like to take a slight step back to note how Canada has been behind when it comes to Lyme disease. Here, I refer everyone to a response tabled by the government on November 15, 2011, in response to an order paper question from my colleague and friend, the member of Parliament for Etobicoke North. In that answer the government said:

The percentage of Lyme disease cases thought to be reported is unknown at present as Lyme disease has only recently become reportable.

Recall that was in 2011. Now less than three years later we know the reported cases of Lyme in Canada jumped 146% between 2009 and 2012. According to the Public Health Agency of Canada, 315 cases of Lyme disease were reported in 2012. According to CanLyme President Jim Wilson, the actual number is likely to be in the thousands given the massive under-diagnosis and under-reporting of the disease. The first reported case of Lyme disease in Quebec was in 2004. It was not until 2008 that the first case was confirmed inside the province.

Referred to as the “great imitator”, Lyme poses great difficulties for medical practitioners because it presents symptoms that are quite nebulous. Indeed, symptoms include joint pain, headache, and fatigue and these can easily be mistaken, and often are, for other illnesses.

Moreover, tick bites often go unnoticed and it is therefore difficult for doctors to recognize early stage Lyme based on initial symptoms that are generally associated with more benign conditions like the flu. It can also be very difficult to diagnose Lyme in children, who may not notice or communicate that they have been bitten by a tick. Indeed, in one recent study published by the journal Arthritis & Rheumatology, the first such study to identify the effects of untreated Lyme infection in children, researchers found that 76% of patients did not recall even having a tick bite.

If diagnosed early and treated with antibiotics within the first six weeks of an infection, the chances are high that a Lyme disease patient can achieve a full recovery. However, if left undiagnosed, the disease can quickly escalate: patients can develop a variety of neurological symptoms and are much more likely to develop debilitating and chronic conditions including arthritis and even facial paralysis. Currently, researchers at a new Lyme disease research facility, funded in part by the non-profit organization CanLyme, are preparing to use genetic testing to determine the extent to which some chronic diseases such as multiple sclerosis, fibromyalgia, and Alzheimer's may in fact be the result of Lyme or other tick-borne infections.

It is clear that my background is not in medicine. Yet I understand as others in the House have said that much research remains to be done and the medical community itself is engaged in a debate over Lyme disease and its impacts over the long term.

This is in part what makes the bill so important. It allows medical professionals to share with each other and with policy-makers across the country at the federal, provincial, and territorial levels their evidence and best practices in order to facilitate a standardized approach to diagnosing and treating this disease.

In particular, the bill would require the Minister of Health to convene a conference bringing together his or her counterparts, representatives of the medical community, patients' groups, and other stakeholders to discuss this important issue. Through collaboration with the provinces and territories and medical professionals, this bill would result in the development of a national strategy to address the challenges posed by the growing risk of exposure to Lyme disease in Canada. As has been acknowledged during previous debate on this bill, Lyme disease poses a major health problem about which Canadians are not sufficiently aware and for which we remain still ill-prepared.

Other members in this place have acknowledged the laudable intent of this bill, which the member for Saanich—Gulf Islands detailed in her remarks and has spoken to as eloquently as one could. As she explained, this is a bill that would deal with the threat of Lyme disease by creating a national surveillance system to address the problems of under-reporting and misdiagnosis, which we know can have severe consequences. It would also strive to achieve the sharing of best practices by medical professionals and ministers of health in the provinces and territories.

Before I close, I would like to draw attention to one other aspect of this national health crisis, which is the extent to which communicable diseases are inextricably intertwined with our natural environment. The recent explosion of the incidence of Lyme disease is tied to changes in climate and land use that can be difficult to track and may be overlooked by both medical practitioners and policy-makers. Indeed, the recent report by the Intergovernmental Panel on Climate Change specifically noted:

Substantial warming in higher-latitude regions will open up new terrain for some infectious diseases that are limited at present by low temperature boundaries, as already evidenced by the northward extensions in Canada...of tick populations...the vectors for Lyme disease...

Indeed, there are myriad unforseeable ways that climate change and other environmental concerns may affect public health. While this example is apparent now, there will be other such occurrences and we need to make sure that we take a holistic approach to understanding and responding to these types of threats.

Public health concerns of this kind, which require collaboration and education to achieve prevention, are perfectly suited for a co-ordinated federal framework to achieve, as the bill before us expressly sets out, increased public awareness, consensus for best practices, and an up-to-date understanding of emerging evidence regarding how this disease operates.

I trust that the members in this place will join in supporting this initiative by voting for this bill, thereby sending a clear message to Canadians that we are listening to their concerns, we are seeking to do what we can, and that we will act.

In closing, may I add that the member for Saanich—Gulf Islands' initiative in this regard is already having a positive influence. Indeed, just by debating this bill in a multipartisan matter, we are raising awareness and signalling to Canadians that this is a public health issue of national concern that deserves urgent attention and action.

I further trust that we will all join in supporting this bill so that we can take action to find the necessary solutions for the suffering of thousands of Canadians. It is a sad reality, as I indicated at the outset, that Lyme disease remains massively under-diagnosed and largely misunderstood, with the U.S. and Canadian experience differing in this regard. Cases have been skyrocketing along the U.S. side of the Vermont, New York, and Maine border with Quebec, though it should be clear that ticks do not stop at the border, as it has been said in this debate. Indeed, the prevalence of disease-carrying ticks in Canada has increased tenfold over the past two decades and there is just cause for great concern.

I am hopeful that in working together to address the situation, and with excellent bills like this going in the right direction, we will succeed in a common cause. May I conclude, again, by thanking the leader of the Green Party for this important initiative. I join again with all members in this place in expressing our sympathy and solidarity with those suffering from Lyme disease, as well as our support and appreciation to the doctors, nurses, and researchers seeking to combat Lyme disease and treat those afflicted with it.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Mr. Speaker, I am honoured to speak to an issue as important as Lyme disease. I would like to acknowledge the work of my colleague from Saanich—Gulf Islands in bringing forward this very important initiative.

This disease is spreading in Canada, and it is expected to continue to spread in years to come. That is why we have to act quickly. Bill C-442, the bill introduced by my colleague, is a step in that direction.

As was said before, Lyme disease, caused by the bacterium Borrelia burgdorferi, is transmitted through tick bites. In addition to causing serious symptoms, the disease can cause serious health consequences, affecting the joints, the heart and even the nervous system.

In Canada, ticks that can transmit Lyme disease are found in the southern parts of Manitoba, Ontario and British Columbia, as well as in some regions in New Brunswick, Nova Scotia and Quebec. In Quebec, ticks that carry the bacterium are found in the Montérégie region in particular.

The Bulletin québécois de vigie et d'intervention des maladies infectieuses, produced by the Bureau de surveillance et de vigie of the Direction de la protection de la santé publique, shows that there has been a significant increase in the number of Lyme disease cases in Montérégie.

In 2012, the number of cases increased considerably, going from 16 in 2007 to 43 in 2011. My riding is in that region, and I am greatly concerned by Health Canada's inaction in containing the spread of the bacterium.

Today, Mont-Saint-Bruno is a risk area, where many ticks spreading the disease can be found. We must start a national campaign to warn Canadians that these ticks exist in their region.

As early as 2008, a New Democratic member of Parliament, Judy Wasylycia-Leis, was asking the minister of health to implement a strategy to protect Canadians against an increase in the number of cases of Lyme disease. Her requests fell on deaf ears. However, five years later, we are seeing the disease progress exponentially.

At the time, the government turned a deaf ear. Now it can no longer deny the urgency of the situation. Lyme disease will continue to spread, because it goes hand in hand with global warming. Winters are not as cold as they once were, allowing the ticks to survive more easily. Inevitably, more places will become risk areas.

We must therefore be proactive in establishing a national medical surveillance program to track incidence rates, a solution proposed in Bill C-442.

Since 2009, Lyme disease has been a nationally reportable disease. That means that all medical professionals must report cases of Lyme disease to the Public Health Agency of Canada through the provincial public health system. This imperative must go hand in hand with preventive measures and programs tailored to public health needs. However, nothing specific has been done to date.

We have heard testimony from those suffering from Lyme disease who have had to deal with ignorance of the disease on the part of some doctors. The observation is alarming, but doctors are overlooking the disease because the blood tests used to diagnose it are very unreliable.

Existing diagnostic tests are effective when Lyme disease is spread, but not when it is in the early stages. Furthermore, people with Lyme disease are often misdiagnosed.

A number of specialists believe that the ELISA tests used in Canada are inadequate. A recent study at Johns Hopkins University, one of the most prestigious medical schools in the United States, showed that the ELISA test protocol for Lyme disease could not even detect the disease in 75% of patients. That is not right. The federal government needs to show some leadership on health care and needs to find ways to better protect Canadians' health by coming up with more effective and efficient solutions.

Canadians need a national Lyme disease strategy, which is why I strongly support Bill C-442, which was introduced by my colleague. This bill is effective. It proposes some guidelines for preventing, diagnosing, treating and managing the disease, as well as for creating and distributing educational material for health care professionals.

There is little documentation on people affected by Lyme disease, and their health care is often mismanaged. Research to improve the diagnostic process should be a priority so that we can prevent incorrect diagnoses.

Such a strategy has been needed for a long time. Canadians' health cannot take a back seat. The government needs to roll up its sleeves and work with the provinces to adopt measures to control this pandemic. Now is the time to take action. I fully support Bill C-442, and I urge my colleagues to do the same.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I would like to thank all of my House of Commons colleagues. It is a great honour for me because this bill has received support from all of the parties in the House.

I am quite overwhelmed with gratitude for this effort to bring forward something in a non-partisan spirit to help people across Canada who have been exposed to bacteria-bearing ticks and who have, as a result, suffered from Lyme disease. They are going to have help.

The fact I brought forward the bill in a non-partisan fashion has been received in equal measure as a non-partisan effort, as was evidenced by the speeches we heard here today and earlier. I will mention particularly the member for South Shore—St. Margaret's, himself a parliamentary secretary and part of cabinet as a result, who spoke so passionately about why we need to act on Lyme disease, and equally so the members today for Oakville, Toronto—Danforth, Saint-Bruno—Saint-Hubert, and Nanaimo—Cowichan. I was particularly struck by the member for Mount Royal. For him the experience of Lyme disease is very personal, because his daughter was exposed to it and suffered from it.

I am probably most grateful, more than to any other individual, to someone who has not spoken to the bill. That is the hon. Minister of Health. Without her support it would be much harder to imagine that we would see the bill leave this place and go quickly to the health committee, where I hope we will have constructive amendments, which I have already discussed with the Minister of Health, to avoid any interjurisdictional problems with the provinces.

I hope to see the bill passed in the House of Commons and go directly to the Senate. Right now I think it is not a question of if the bill is passed, but when, and how quickly we can get help to the people who are suffering from Lyme disease.

My thanks go also to the College of Physicians and Surgeons of Ontario and to the Canadian Medical Association for their quite clear stand in support of the bill to bring the support and the help people need at the level of prevention through greater public awareness, adequate treatment, quick diagnosis, and further research.

To have all these things happen through the sharing of best practices, we need all the players around the table: provincial, federal, and medical experts, as well as the people in the Lyme disease community themselves, who have rallied around the bill, collected thousands and thousands of names on petitions, and delivered them to their MPs.

My thanks go out to all. Let us see the bill passed, and quickly.

[The Acting Speaker, Conservative, Bruce Stanton]

The question is on the motion.

Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[The Acting Speaker, Conservative, Bruce Stanton]

I declare the motion carried.

Accordingly, the bill stands referred to the Standing Committee on Health.

(Motion agreed to, bill read the second time and referred to a committee)