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.

Lyme Disease

[Chris d'Entremont, Conservative, West Nova, NS]

Mr. Speaker, Lyme disease is a huge concern in Nova Scotia. People can suffer undiagnosed for years, pleading with their health care professionals to be tested and referred.

In 2018, Nova Scotian residents reported the second highest number of Lyme disease in Canada with 451 people. With these high numbers in such a small province, one would think we would have the best Lyme treatment program in Canada, but sadly, residents continue to travel outside our country for treatment.

While this is unacceptable in regular times, it is almost impossible during this pandemic. Bill C-442 was unanimously passed in 2014. This bill was supposed to identify and implement new diagnostic treatments or protocols for tick-borne illnesses, changes that have been painfully slow.

I recently read the story about Hailey Kane from the Annapolis Valley, a 17-year-old girl who lost her life to Lyme disease. Hailey's family can never escape the nightmare that is a result of this undiagnosed, untreated Lyme disease. We need to do better. We need to call on all levels of government to do better for these patients, who have had their quality of life taken from them or, worse, pass away before ever getting the help that they need.

Latin American Heritage Month Act

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

Mr. Speaker, it is an honour to rise tonight to speak to Bill S-218, a bill for the creation of a Latin American cultural month in the month of October. Obviously, this is a heated debate over a very controversial bill, which is why we have six hours devoted to it.

I have been a member of Parliament for seven years. This is the first time I have been allowed to rise in debate during private members' hour when it was not my own bill. I spoke to my own bill, Bill C-442 in the previous Parliament, which created a Lyme disease strategy. For those who are political nerds and might wonder why it would be that a member in my position does not usually speak to a private member's bill, it is because private members' business is usually brief and speaking slots are hard to find. For some reason this evening I was able to get a much-coveted speaking slot on a Latin American heritage month for Canada.

For viewers, or historians opening up Hansard at some point covered in dust some decades from now, we should reveal that the successive six hours of debate on a non-controversial private member's bill is a tribute to political and procedural shenanigans in this place, and somehow or other, credit or blame—one might say how clever—is to Conservatives, who managed to force an extra five hours of debate on this bill. That is not to minimize that this is a great bill, but I do want to explain why we are here.

To anyone watching or anyone who cares about Latin American heritage, as I do, there is no disrespect intended, but there are more pressing matters facing the nation. However, tonight for six hours we are debating Latin American heritage month.

I want to turn my attention to that and start, as others have, by paying tribute to a departed colleague from the other place, Senator Enverga, whom I knew. His death was a terrible shock to all of us. He was on parliamentary business when he died quite suddenly, and it was a terrible thing as is always the case when someone dies unexpectedly doing his or her work on behalf of this place. This private member's bill comes to us from someone who did not have Latin American heritage, and that is quite interesting.

I am happy to support it. I want to say that in my riding of Saanich—Gulf Islands, while we have a very vibrant community that is Latin American, it is indeed small. Spanish is spoken and Portuguese is spoken, but not by very many. I do want to share, though, that Spanish names and Spanish heritage are commonly found in the geography of place. In the colonial waves that came across Turtle Island, the Spaniards of course came. Looking at my riding, my representation is Saanich—Gulf Islands. “Saanich”, of course, is indigenous, from the Sencoten word: WSÁNEC. It actually means “the people who are rising”.

However, in the Gulf Islands there is Galiano Island, which is named after a Spanish explorer from 1792. There is Saturna Island. Saturna Island is actually named for a naval schooner, not a person. The Santa Saturnina came to the Gulf Islands in 1791. I could digress and discuss the pig war that took place at Saturna Island. It was a hotly contested piece of real estate. It is amazing that it is not now. If there are people who have never really looked at a map of southern Vancouver Island, they should because they will find that where I live is actually south of the 49th parallel and I look due east at the state of Washington. It is a territory that is entirely shared lands and waters.

Some of those shared waters are the Strait of Juan de Fuca. Juan de Fuca goes way back. Juan de Fuca was actually a Greek, but he was exploring on behalf of King Philip II of Spain in the 1580s. The Strait of Juan de Fuca is one that is terribly threatened by Aframax tankers loaded with dilbit, but that is a different debate.

The entertainment from across the way may distract me from telling members about Portuguese Joe, but this is fascinating.

Portuguese Joe was the first European to live in Stanley Park. He was born in the Azores in 1828, and he lived in Stanley Park outside of where Vancouver is now. He married the granddaughter of none other than Chief Kiapilano. He really brought Portuguese culture and heritage to Vancouver proper, the Lower Mainland, and in his later years, he moved to Reid Island. He actually bought a chunk of Reid Island, which is off Galiano Island.

He passed away on Reid Island, having had two first nations wives. The first was, as I mentioned, the granddaughter of Chief Kiapilano, and the second was from the Sechelt Nation.

All of this connects indigenous culture and Latin American culture, on which is I want to reflect.

So far tonight we have talked of Latin American culture exclusively in its colonial connotations. We have talked about Spanish dancing, Latin language, and yummy food. Let me just cast our minds to the reality that Latin America is an indigenous place. We stand tonight on the traditional territory of the Algonquin Nation, and much of Latin America is the traditional territory of the Mayan people and the Quechua-speaking peoples.

This is being reflected at UBC right now. For anyone who wants to go to UBC's Museum of Anthropology, starting on May 17 and running until October 8, there an exhibition entitled “Arts of Resistance: Politics and the Past in Latin America”. There is a write-up in The New York Times if members want to read about it.

Those who put this exhibit together looked at political overlay with respect to how politics and oppression showed themselves in the art of indigenous people of Latin America. It might seem incongruous that of all places in Canada, an exhibition like “Arts of Resistance: Politics and the Past in Latin America” is on display in the Museum of Anthropology at UBC.

I do not know how many members have been to the Museum of Anthropology at the UBC campus, but it is a spectacular place, overwhelmingly devoted to British Columbia culture and indigenous arts. There are a lot of original Bill Reid pieces, carved totems, and art from the Nuu-chah-nulth, Haida, and Saanich. There is a whole range of indigenous art from British Columbia. That is the place people can go to get a sense of the kind of art that is expressed from people who are marginalized and oppressed by colonialism within Latin America.

The connections between Canada and Latin American are not only those found in our shared colonial history, those who have moved to Canada who come from a colonial past. Many people who have come to Canada from Latin America also come from that indigenous tradition. Whether they are from Honduras, Guatemala, Mexico, or whichever Latin American country, they also often come with a connection to their indigenous traditional past, and that culture infuses so much richness into history throughout Latin American.

By the way, one of my constituents, Ronald Wright, is a bestselling author who has documented these connections well in his book Stolen Continents, through his review of indigenous culture in Time Among the Maya, and through a lot of reflection on indigenous culture in A Short History of Progress, although the latter mostly focuses on the foibles of hubris, western civilization, and greed.

I believe this controversial bill on Latin American heritage month will pass, and we will celebrate every October with great gusto across party lines. If nothing else, the bill brought parliamentarians together on a June night in 2018 for the second hour of a six hour debate. This debate allows us to say Latin American culture is alive and well in Canada, and we celebrate it.

Meegwetch. Gracias. Muito obrigado.

[Colin Carrie, Conservative, Oshawa, ON]

Okay. Maybe we can get back to you on that.

My next question is for Dr. Hawkins.

First of all, I just want to say that when we are looking at the original Bill C-442 around the table here, I am very proud to have worked.... To get a private member's bill passed by a government is a great feat, actually, but I think the original intent was to have a framework come out that was going to make Canada's the most up to date one around the world.

From the evidence I've been hearing in the last couple of days, as far as guidelines, diagnostics, and treatments are concerned, it seems that our latest framework is failing in that regard. The bill did call for treatment. Dr. Njoo said we should be focusing primarily on diagnostics and treatments. I do realize there are jurisdictional issues there, but I'm worried that we didn't quite get it right.

Dr. Hawkins, the framework highlights the current challenges associated with Lyme disease testing; however, it doesn't actually offer any recommendations for replacing or repealing the current methods being used. I know you commented earlier today, but could you give us some specific guidelines? What changes do you think should be made, and what are the consequences of continuing to use these old methods?

[Dr. Elizabeth Zubek, Family Physician, Shepherd's Hill Medical Clinic, As an Individual]

Good morning. I'm Dr. Elizabeth Zubek, and I am a clinical instructor with the University of British Columbia Faculty of Medicine, department of family practice. I've also worked, from 2013-14, as a UBC consultant on the treatment of Lyme disease, with the university's complex chronic disease program, which was created to be a central provincial referral site for patients with Lyme disease. I now work in private practice, with the treatment of tick-borne infections occupying about 20% of my time.

I'm honoured to be chosen to speak at the House of Commons Standing Committee on Health regarding an action plan, the federal framework on Lyme disease. You, as our federal MPs, listened to the suffering of Canadians with chronic Lyme disease. You responded to the thousands of people in your constituencies who presented evidence that Lyme disease is not being properly diagnosed and treated in Canada. You had the courage to vote unanimously to create an action plan to correct these issues. Now it's time to take this information, designate the funding, and create a solution for all Canadians.

I urge you to remember the why, the impetus behind Bill C-442: Canadians becoming disabled from a treatable disease. This should inform our decisions.

Three pillars are addressed by the framework: surveillance, education and awareness, and guidelines and best practices. I would like to address each of those three pillars in succession. I'll address these from the perspective of a family physician and from the perspective of one of the few Canadian physicians specializing in the treatment of chronic tick-borne illnesses.

On surveillance, although surveillance is already being funded by the Government of Canada for Borrelia burgdorferi, we know that data obtained becomes obsolete quickly due to climate change and due to migratory birds, as they travel, spreading ticks into new areas. There is no region in Canada that can be considered safe from Lyme disease. As a family doctor, I assess the patient in front of me. If that person was bitten by a tick and develops an unusual rash, or neurological or arthritic symptoms, it doesn't matter to me whether the rate of infection in ticks in my area is 5% or 20%, I treat the person in front of me, and I need appropriate testing for tick-borne disease in that scenario.

We know there are multiple species of Borrelia, at least 10 of which cause human disease, and multiple strains among each species. There are then other Borrelia species that cause a relapse and fevers. We know that ticks carry multiple other bacteria, viruses, and parasites. I think it's more important to allocate our resources to test the sick human for the presence of disease rather than count how many ticks in a field contain the Borrelia bacteria. Surveillance has its role, and new Lyme cases are reported, but this already has some funding. Sick people need diagnosis and treatment, not more regional statistics.

Education and awareness is the second pillar. This is very important to prevent new cases of Lyme disease and to recognize symptoms of chronic infection. I believe the entire process of this framework has robustly increased education and awareness in Canadians. There's been so much press about Bill C-442, the all-party support, the controversies involved, and the media has effectively done more than any print campaign the government could have devised. As such, my recommendation would be that the dollars attached to this area of education and awareness be designated towards physician education.

I work in a region of B.C. that's considered endemic for Lyme disease, yet I frequently hear physicians saying, “Lyme disease isn't found in B.C.”, or physicians suggesting a Lyme test immediately after a tick bite, when the test couldn't possibly be positive yet. I teach final year medical students who have not learned about acute and chronic manifestations of Lyme disease. It is to physicians that educational efforts must be directed.

The third pillar is guidelines and best practices for diagnosis and management. On best practices for diagnosis, this framework recognizes that testing with better sensitivity is needed. We cannot accept the current two-tier tests, which as Ralph said, only have a 40% chance of picking up disease, and that's only if you're lucky enough to have your disease caused by one particular strain, B31, of one particular species, sensu stricto, of Borrelia.

Better tests exist now. I recommend that funding go toward evaluating the ELISpot test in our Canadian population. The ELISpot is a lymphocyte transformation test. This type of testing is accepted in Canada as the gold standard for assessing active versus latent or dormant tuberculosis, which is another spirochete disease.

The ELISpot can diagnose 84% of Borrelia infections, is positive earlier in the course of disease, and will go down to zero when treatment is completed. This has added benefit in areas of high endemicity, where a person can be reinfected after the treatment was completed. ELISpot testing currently costs between $200 and $400. Patients, as Ralph said, are now paying for it out of pocket. But it is being used by most of the treating doctors I know in Canada. Better testing for Canadians must be a top priority.

Finally, there are best practices for management. The framework recognizes there are two different approaches to management. One guideline is supported by the Infectious Diseases Society of America, IDSA, and the other is supported by the International Lyme and Associated Diseases Society, ILADS.

In evaluating the trustworthiness of any set of guidelines, specific criteria must be met, as outlined by the respected Institute of Medicine. Guidelines must include regular review and monitoring as new research becomes available. A multidisciplinary panel of experts and representatives from key affected groups, patients, update the guidelines.

Only one set of guidelines meets these criteria, the ILADS guidelines of 2014. These are on the U.S. National Guideline Clearinghouse website and used internationally. Strangely, we in Canada have not publicized these very current and evidence-based guidelines for doctors to use in Canada. We still post the old IDSA guidelines, published over a decade ago, in 2006, never revised, and which were discarded from the U.S. National Guideline Clearinghouse well over a year ago.

This is a critical point to address. There has been an explosion of research on Borrelia this past decade. We have discovered that Borrelia has three different shapes or morphologies and it switches easily between them. The three forms include a corkscrew shaped spirochete with a cell wall, an intracellular form, and a round body that is a more dormant form. It takes a different type of antibiotic to treat each one of these three forms. As a result, the most effective protocols use three different antibiotics all together or in a pulsing pattern.

I looked on the PHAC website just last night for any treatment advice for late Lyme disease, and in its “for physicians” section, it linked me only to a 2006 article of treatment protocols. Those old protocols use only one antibiotic by itself for only two to four weeks, even when the brain is affected. We need PHAC to acknowledge the updated 2014 ILADS guidelines and formally post this most up-to-date information for physicians on their website so that doctors can manage their patients appropriately.

In summary, priorities for funding must align with the priorities of people affected by Lyme disease and their experts. The top two priorities would be diagnosis and management related. For diagnosis, we must evaluate the use of a more sensitive yet still specific diagnostic test such as the ELISpot, and make it available to Canadians immediately as a part of that evaluation. For management, Canadian clinical practice guidelines must consider the most up-to-date research and meet Institute of Medicine standards.

We must do broad education for physicians in all specialties and in general practice. We also need to train up a cohort of physicians with special expertise in the treatment of people with chronic manifestations of Lyme disease. Physician expert engagement must include the College of Family Physicians of Canada, which has a mandate to provide holistic patient-centred care. Family doctors are the ones on the front lines, from diagnosing initial infection to caring for complex systemic diseases.

Finally, it is very important that patients be an integral part of the research direction and research network.

Thank you for your attention today.

[The Chair, Liberal, Bill Casey]

I want to thank the witnesses very much for coming. We have the most interesting meetings at this committee. You talked earlier of the voice of victims not being heard, but your voices were heard today. You've been broadcast all through this on the Internet, and you will be on CPAC, as well, and reruns, so you're voices are starting to be heard. That's part of our process in the committee.

I think when I met with you earlier, I told you that things take a long time here, but they do happen. I believe that process is under way, thanks to Bill C-442.

I want to say thank you very much to Dr. Lloyd. I notice you broke your pen about three times during the meeting. I'm going to make sure you get a new pen from the Parliament of Canada. I'd like you to just quicky tell us what your work is in this area, in Lyme disease and ticks. I just know you've worked on it for some time, but I don't know what your work has been; and have you had any funding from the government?

[Jennifer Kravis, Lyme Disease Advocate and Patient, As an Individual]

Hello. My name is Jennifer Kravis. I live in Oakville, Ontario. Thank you for having me here today.

I used to be a lawyer and a bank executive, but 11 years ago, at age 36, I was suddenly debilitated and bedridden by a mystery disease that took me hundreds of thousands of dollars and five years to determine was Lyme disease.

I had to go to the U.S. and pay even more money. I spent two years getting continuous antibiotic treatment, including a PICC line, which gave me my quality of life back, and my family's as well.

I still cannot work, but I advocate for Lyme disease now. There are five people in my family with Lyme, and my dog has it as well, but my dog was treated promptly with compassion and care, and he got five months of antibiotics, and he made a full recovery. My niece got early treatment with a bull's eye rash after seeing four doctors . The rest of us—me, my mother, and my two daughters—are permanently affected. As a mother, I live with the guilt and horror of discovering I probably infected my two kids. They both have chronic Lyme and multiple co-infections. One has encephalitis causing neuropsychiatric issues and arthritis in the spine, and she's 14 years old.

In the last week I've spent many hours thinking about what I could possibly say to you in 10 minutes to convey to you the suffering, the despair, the abuse, the financial ruin that is sweeping this country.

I can talk about my full story. I was financially secure, a Bay Street professional. I had money, connections, and access to the very best health care, but it did not protect me and my family, and it will not protect you.

I could talk about the 40,000 Canadians who signed our petition or who wrote thousands of Lyme letters for Minister Philpott, letters that bring us to tears on a regular basis. But on Thursday you will be told that petition comments are really about ticks, and stories are anecdotes not evidence.

I could talk about the independent, professional benchmark survey we did in Canada to ask how many people were affected by Lyme disease. The survey asked, have you or someone you know in Canada been diagnosed with Lyme disease? The answer is between 2.8 million and five million people.

Public health numbers are a joke because people are denied testing and not counted. People get false negative results, and they are not counted. People get positive results. They are told they are false, and they are not counted. People get positive tests from international labs, and they are not counted. Finally, those who, by some miracle know about Lyme, convince their doctor to order tests, pass the first tier, pass the second tier, prove they were in an endemic area, get to the doctor in time, get a bull's eye rash, and have the doctor visually inspect the bull's eye rash. Even the majority of those cases are not counted, just as Sue Faber talked about.

I thought about asking questions. Why has public health ignored 35 published, peer-reviewed tick studies compiled over the past 27 years by an Ontario researcher named John Scott? Why has public health not warned first nations that they are living in hyperendemic areas like Kenora, Ontario, where John Scott estimates ticks have been established for 50 years? Why have our doctors never heard of co-infections?

My 13-year-old daughter has Rocky Mountain spotted fever. This is a disease that could be fatal in up to 75% of untreated cases. I had to fight for this test, and when it came back positive, my GP fired us.

This leaves my going back to my original question, which is, what could I possibly say to you to convince you something tragic, shocking, and disturbing is happening in plain sight?

I decided I would speak about the truth, the real truth, the truth that nobody wants to talk about or believe. The truth is the bill was great, but the final framework is useless. It is inaccurate. It's going to cause harm to Canadians. The process was mangled by some powerful, unethical, and self-serving interests.

The truth is we have a massive global pandemic, one that is not easily prevented by pulling your socks up and staying in the middle of the paths. The truth is people are so desperate to get life-saving antibiotics they beg their vets, and they beg their doctors to try to get six weeks of antibiotics in a desperate attempt to avoid lifelong disability. The truth is there's a secret network of Canadian doctors who risk their licences to treat their patients. The truth is Lyme patients are horribly abused by doctors, but if they file a complaint to the college, they are harassed and blacklisted. The truth is millions of Canadians, including first nations and children, are walking around with the wrong diagnosis. The truth is U.S. doctors are getting paid by us to learn about this disease, instead of our own doctors gaining this knowledge and expertise. The truth is we have thousands of parents who live in agony and despair, hiding in their homes with sick, disabled children who scream and cry, have seizures, and are in horrific pain. The truth is people with bull's eye rashes in every province every day are being turned away and denied treatment, sent home to wind up disabled in excruciating, unrelenting pain.

Some doctors say, “I'm sorry, I can't help you; I will get in trouble and I have to protect my family over yours.” Some doctors say, “I'm not allowed to help you, but if you go to the U.S. and get treatment, you will get better.”

Many doctors say, “I guarantee you don't have Lyme disease” and, in fact, they are correct, because the system at every stage guarantees it's virtually impossible to get a Lyme diagnosis. When the Canadian test is negative, it is called gold standard; when the test is positive, it is called false; and when the test is from out of the country, it is called garbage, except if it's negative.

The truth is that surveillance is a sham and a waste of money, because ticks are dropped everywhere by migrating birds; and surveillance is not progress. It is a tool used to deny the disease. The truth is that some people don't get their Lyme test back from the national lab for months, and too many people are told their test results are lost.

The newest weapon in the Lyme war is anti-microbial resistance, which denies very sick Lyme people life-saving treatment or the dangerous side effects of antibiotics. The truth is that people with arthritis, syphilis, Crohn's disease, tuberculosis, relapsing fever, rheumatic heart fever, rosacea, MS, and acne are given months and years of antibiotics without hesitation; and cancer patients are given the choice of drugs with side effects so dangerous they can kill them.

Let's review the so-called facts of Lyme disease that we are told by public health and infectious disease specialists: one, our testing is fine; two, ticks must be attached for 24 to 48 hours to transmit the disease; three, only black-legged ticks carry Lyme; four, your risk of contracting Lyme is very low, so don't worry, and virtually zero outside of endemic areas; five, you can't have Lyme if you don't get a bull's-eye rash; six, two or three weeks of one antibiotic is all you need to be fully cured; seven, if you have any new, lingering symptoms, you have a new disease, which is called post-Lyme-treatment disease syndrome, which looks and feels exactly the same as the infectious disease you just had three weeks earlier; eight, we are told there is no scientific evidence of persistent infection or that long-term antibiotics help, and we are told there's no scientific evidence of congenital transmission.

We are told, “We don't know what all these people have, but it's not Lyme” and we're told that people fixating on Lyme could miss the chance to get a real diagnosis.

Finally, we are told other countries' tests, all of them, are invalidated, from for-profit labs, not FDA approved, purchased positives, garbage, or run by profiteers and quacks. But the truth is every single one of those sentences is untrue.

The truth is that doctors, patients, and the public are being misled, and we need you to do what no one has been able to do—despite fighting for decades—not advocates, not Bill C-442, not celebrities, not politicians, not journalists, and not even an international organization of medical doctors and scientists.

We need you to ask yourselves if it makes sense that tens of thousands of Canadians have a shared delusion about their own health and welfare, their body, and their symptoms? Does it make sense that tens of thousands of kids who've never met are suffering from a shared psychiatric disease that causes them to fake symptoms? Does it makes sense that previously rational, healthy adults are conspiring to obtain antibiotics, which if abused, give you a stomach ache and a sunburn. Does it make sense that desperately sick people bankrupt themselves for treatments that provide no relief to them?

We need you to ask the questions that always reveal the truth. Who benefits or profits from the denial and suppression of these diseases? Who benefits from patients missing the early cure with a cheap generic antibiotic, and wind up labelled with fibromyalgia or an incurable neurodegenerative disease like MS, ALS, or Alzheimer's. It's not patients, it's not taxpayers, it's not families or kids, it's not businesses, it's not our health care budget, it's not family doctors or clinicians, and it's not our economy.

The truth is that it is too late for me and my family, because there is no amount of money, drugs, connections, or treatments that will restore our health. We are here for you. We are here for all those Canadians who are so sick and in pain and feel abandoned and are on the verge of suicide. We are here for all those Canadians who will be unknowingly struck down in the parks and in their backyards. We are here because we cannot bear to hear one more story of a child with a bull's eye rash being sent away to end up disabled.

The truth is that Canadians desperately need you to stand up and do the right thing. We need your help. Please help.

Thank you.

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

Thank you, Mr. Chairman, and thank you to all members of the committee. I will not trespass long on your time, because we have with us people I want you to hear.

I wanted to set a bit of context. Some of you were in that Parliament—Don, certainly—in June 2012 when I first tabled Bill C-442 for first reading. We have had tremendous non-partisan, all-party support from the beginning. The bill was supported in the House of Commons unanimously and went to the Senate, where it was also supported unanimously.

The bill's nuts and bolts required a conference to be held, bringing in medical experts, federal-provincial government health departments, and people from what we now think of as the Lyme disease community, people such as some of the witnesses before us today, Sue and Jennifer.

I wanted to give you a sense that the conference was an extraordinary success. Our public health officer at the time, Greg Taylor, was very strong in saying that we needed to do more. We've been failing our patients. We've been failing people with Lyme disease across Canada.

I wanted to say briefly that now that the framework has been published, the committee's work for two days this week is very important. I know you'll hear evidence about how serious Lyme disease is, how fast it's spreading, and frankly, the hell on earth it has been for patients with Lyme disease. One of my constituents went to 18 different specialists before finally thinking, “Okay, maybe we'll try going to the States,” and then finally got some help.

The bottom line here, I believe, is that any Canadian experiencing Lyme disease should be able to get treatment in Canada, and we're not there yet. The Minister of Health herself doesn't have a magic wand, nor does she have the jurisdiction to make it so, but the framework gives us some tools. I wanted to point us in that direction, as the positive work going forward.

In the framework document, in appendix 1 is the federal action plan. I wanted to turn your attention to point 2 on education and awareness and point 3 on guidelines. Both of these sections point us in the direction of finding ways to educate medical professionals.

Medical professionals are a very educated bunch. I have the deepest respect for the doctors of this community. In fact, the Canadian Medical Association endorsed Bill C-442. Their letter endorsing it made the point that Lyme disease is an extremely difficult disease to diagnose. The advice, which I agree with in this framework, is that the diagnosis is primarily a clinical diagnosis. In other words, lab tests are quite unreliable, no matter where they are taken. False positives and false negatives are problems.

What we need, when someone presents with a weird range of symptoms, is for every medical doctor in Canada, every family doc, to think to themselves, “I wonder if it's Lyme disease.” If you respond quickly and with early treatment, if it is Lyme disease, this person will be restored to full health, but if you delay, thinking that maybe it's something else, you can actually end up having the disease become much more serious and last much longer.

Here are the two pieces I'm referring to. Under “Education and awareness,” it reads:

Develop a national tick and Lyme disease education and awareness campaign

—this is the federal commitment—

in collaboration with partners, that addresses...Recognition of Lyme disease symptoms [to assist] front-line professionals [to] perform early diagnosis and treatment

Then, under “Guidelines and best practices,” in point 3, it says:

Work with international public health partners

—because, by the way, Lyme disease is spreading very quickly in Europe—

to share best practices and disseminate domestically

These are areas where we don't yet have a clear sense of how we're going to do it. The commitment is there. It's clear that we can't polarize this issue with good guys and bad guys. That's not appropriate. Everybody here is a good guy. Everybody is trying to figure out what to do, to use the right tools, and to start ensuring that every Canadian who experiences Lyme disease is helped.

There are many people who have had it for a very long time, and those particular patients are a represented group where the research money will be very helpful. We have $4 million for research. That money, I hope, will go towards finding a vaccine but also towards finding ways to help people who have what's either described as post-treatment Lyme disease syndrome or chronic Lyme disease. I don't want to get involved in that ideological divide. I just know there are a lot of people in wheelchairs who need help.

I've taken longer than I actually told you I would, Mr. Chair. You said I could have five minutes. I said I wouldn't need that, but at 4 minutes and 43 seconds I will stop, and I thank you for your attention.

[The Chair, Liberal, Bill Casey]

As we have quorum, I'd like to welcome everybody to meeting number 59 of the Standing Committee on Health.

Today we're going to study the federal framework on Lyme disease. We have three witnesses here with us in the meeting room, and we have by video conference a visitor from Sackville, New Brunswick.

On behalf of the Canadian Lyme Disease Foundation, we have Janet Sperling, board member. Then we have, as individuals, Sue Faber, Lyme disease advocate and patient; Jennifer Kravis, Lyme disease advocate and patient; and Dr. Vett Lloyd, professor at Mount Allison University, by video conference.

Welcome all. We're glad to have you here.

I'm going to seek unanimous consent to allow Elizabeth May to just make a few opening remarks because I believe we can say we're here because of her original Bill C-442, which resulted in this framework being established.

Do I have unanimous consent to allow Ms. May to make a statement?

Member for Sturgeon River—Parkland

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

Mr. Speaker, I rise today to pay tribute to my colleague and friend.

I met the member for Sturgeon River—Parkland 11 years ago.

I was not in politics yet. I was executive director of the Sierra Club Canada when I first sat down at a table opposite the current interim leader of the Conservative Party. She was then-minister of environment. It is a tribute to her personal characteristics of fairness, kindness and just plain likable that I could not help liking her as we discussed the Kyoto protocol.

I have searched my memory banks and I cannot remember a single time in the last 11 years when I have not thought well of her as a person, even if we disagreed. We share many things, including a love of dogs and hiking in the wilderness, and we also shared much when she was minister of health. I want to pause for that period and thank her once again.

She played a key role in ensuring the quick passage of Bill C-442 on Lyme disease. We are now working together on the national framework that will be implemented under that bill.

However, it took the minister of health deciding that a private member's bill from an opposition party leader would be okay to support. To have it pass unanimously in the House of Commons and the Senate is not about all the independent decision-making of all the MPs. Honestly, if the minister of health had not supported that bill, it would have died right there. I want to thank her once again for supporting remedies for the people across this country suffering from Lyme disease.

I also want to pay personal tribute to the fact that under her leadership and in the government of Stephen Harper, the strongest legislation ever, taking big pharma to task, Vanessa's Law, was passed. That is solid and it is a tribute I want to pay publicly.

Last, as another woman in politics, leading a teeny-weeny party over here in the corner, everything she has ever done as interim leader of the official opposition has demonstrated that women can do everything just as well as a man.

I saw her earlier today, standing at the podium in the foyer. I do not know how she stands in those shoes. I do not understand how anyone can walk in those shoes. They are phenomenal high heels. They are very gorgeous. It reminded me so much of what was often said of Ginger Rogers and Fred Astaire, that she danced just as well as he did but backwards and in high heels.

Hats off to the leader of the official opposition. We will miss you.

[Len Webber, Conservative, Calgary Confederation, AB]

I do, Mr. Chair.

I would like to present the following motion, which was submitted in advance, of course, as per the committee requirements. The motion reads as follows:

That the final framework on Lyme disease not be tabled until the Standing Committee on Health has had the opportunity to review the draft work which should aim to (a) establish proper guidelines regarding the prevention, identification, treatment and management of Lyme disease and the sharing of best practices throughout Canada, and (b) ensure the creation and distribution of standardized educational materials related to Lyme disease for use by any public health care provider within Canada designed to increase national awareness about the disease and enhance its prevention, identification, treatment and management.

I table this motion because a year ago, almost to the day, there was a clear sense of hope in the Lyme disease community. A federally funded Lyme disease conference was held right here in Ottawa in May of 2016. There was a sense that finally experts in the field of Lyme disease would be engaged in the drafting of the federal framework outlined in Bill C-442, MP Elizabeth May's bill.

The Federal Framework on Lyme Disease Act was passed on June 11, 2016. The MPs and senators who passed this bill into law passed it with the understanding that it was to be consultative. But that sense of hope has faded. This federal framework on Lyme disease is being written behind closed doors. It is to be released later this month.

A draft framework was released in February of this year, and the reaction to it was fierce. Dr. Melanie Wills, director of the Canadian Lyme Science Alliance and a professor of molecular and cellular biology at the University of Guelph, said the following:

As a researcher in the field of Lyme disease biology, I am dismayed by the lack of scientific rigor, collaboration, and leadership demonstrated in this document. The Framework does not provide a balanced or holistic portrayal of the biomedical literature, nor does it capture the experiences and needs of Canadians who are suffering from Lyme disease. The CLSA strongly advocates a thorough, inclusive, critical, and transparent evaluation of all available meritorious scientific evidence, as well as meaningful integration of input from diverse stakeholders. We can, and must, do better.

Dr. Liz Zubek, a family physician who specializes in the treatment of Lyme disease, said the following:

This draft Framework tells me to follow outdated guidelines that haven’t been revised in over 10 years. There has been an explosion of research in the past decade and newer guidelines exist that include patient input. This draft Framework also suggests that, as a doctor, I should be satisfied with our inadequate Canadian tests for now, and that maybe in the future we will find improvements. This is, frankly, ridiculous.

I urge the Minister of Health to reject the Draft Framework and insist on a real Canadian action plan for Lyme disease. This needs to be created in partnership with people affected by Lyme and those researchers and doctors who are actively attempting to treat them.

Finally, these are the words of Rossana Magnotta, a director of the Canadian Lyme Disease Foundation:

We call on the Minister of Health to intervene and insist on patient experts being involved in the writing of the framework, even if that means delaying the report to parliament. This is the correct and ethical thing to do.

Mr. Chair and colleagues, 38,000 Canadians have signed a petition clearly denouncing Canada's draft action plan on Lyme disease. The draft proposal ignores science and many major concerns that were raised at the conference. Major concerns include poor diagnosis, treatment plans that fail, human-to-human transmission, and blood bank contamination—yes, blood bank contamination.

You can see that there are some serious concerns by both professionals and patients within the Lyme disease community that this framework may lack some key items. I would like to give the Lyme disease community reassurance that they are included in the drafting of this framework. I am aware, colleagues, that this committee has no more days or time available in the near future to undertake any more studies. I'm aware of that, and I'm also aware that Health Canada intends to release this framework on Lyme disease at the end of the month.

Therefore, this motion I put forward proposes that, through the clerk, of course, we receive a copy of the framework in advance of the final copy being generated so that we can add our constructive input. I'm suggesting that we can review it independently, on our own time, as our meeting schedule is already full.

In the end, it will be we MPs who will have to answer to this framework, and it sure would help if any questions we have could be resolved ahead of the drafting of the framework. I think our input would be most valuable if it is contributed before the document is finalized, because once this framework is written, it's basically written in stone. It would be difficult to change.

Ideally, I would imagine that we could have a draft framework document for about a week to provide our input before it goes to final print, and if this proves to be a successful approach, it may help this committee in future issues.

I conclude with this question: do we all agree that having our input would be a valuable contribution to the process of developing an action plan framework on Lyme disease?

Thank you, Mr. Chair.

[The Chair, Conservative, Ben Lobb]

Welcome back. We're back in session.

We'll start going through the clause by clause portion of Bill C-17. We have the departmental officials at the table, at the ready, if there are any questions. So feel free to ask questions or for clarification.

In addition to that, similar to what we did for Bill C-442, the Lyme disease bill, we'll take our time and make sure everybody knows exactly what clause and what amendment we're talking about, so everybody feels good about what they're voting on.

There's lunch at the back and recognizing the fact that everybody wants to pay attention to the clauses and the amendments and to which way to vote, we can suspend at some point, when the committee feels like it, for five to 10 minutes, just to have a quick lunch so that everybody can stay focused on the clauses and the amendments, if that's okay with everybody.

We have two legislative clerks here to help us along the way if we have any technical questions. Karin is also still here as our analyst.

If everybody's ready to go, we'll get at it.

Similar to the case with the Lyme disease bill, the title and the preamble will wait until the end, and we'll get right at it.

(On clause 2)

We have amendment CPC-1. On that, I'll say that if this amendment is adopted, so will be amendment CPC-2 since they are consequential. Would somebody like to talk about the amendment?

Ms. Adams.

Federal Framework on Lyme Disease Act

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

Mr. Speaker, I am deeply indebted to all members on all sides of the House. I will not need my five minutes, as I do not plan on making a long statement.

I want to close at this third reading of Bill C-442 by turning our attention to the people who are suffering with Lyme disease. I want to thank Jim Wilson and the Canadian Lyme Disease Foundation, Brenda Sterling in Nova Scotia, who first made me aware of the disease through her own suffering, and my dear friends and the family of Fraser Smith. I particularly want to thank Nicole Bottles for her amazing advocacy, struggling herself against the debilitating effects of the disease.

I want to thank members on all sides of the House. We have done something good today for people who need our help.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Speaker, Canadians need a national strategy on Lyme disease to ensure that testing and treatment options in Canada are improved.

The New Democratic Party of Canada supports Bill C-442 and congratulates the member for Saanich—Gulf Islands on her initiative.

This legislation lays out a concise plan for educating Canadians about disease risks and most important, provides a better quality of life for Lyme disease sufferers.

Lyme disease is caused by contact with the bacterium spread by tick bites. Ticks are small parasites that feed on the blood of animals and humans, and they pass on Lyme disease when they feed on mice, squirrels, birds, or other animals that carry the bacterium, and then bite humans. Ticks are more common during the warmer months from spring through to late autumn. Canadians who live in areas with mild winter temperatures and minimal snowfall have an increased risk of coming into contact with ticks.

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.

Bill C-442 is especially important to British Columbian coastal communities, as Lyme disease is currently more of a concern on Canada's west coast due to its mild temperatures.

Lyme disease symptoms can include a circular rash around the bite, fatigue, fever, headache, weakness, abnormal heartbeat, muscle and joint pain, and central and peripheral nervous system disorders. Symptoms get progressively worse if the disease is left untreated, which it is for many Canadians. Chronic Lyme can develop if the disease is left untreated and can have lasting effects for months or years afterwards, and according to Health Canada, can result in recurring arthritis and neurological problems.

In 2008, NDP MP Judy Wasylycia-Leis urged the health minister to implement a national strategy to diagnose, treat, and create better surveillance of Lyme disease. I am proud of the member for Vancouver East, our official opposition health critic, who has continued to call for a national Lyme disease strategy since that time and seconded Bill C-442 when it was introduced by the member for Saanich—Gulf Islands.

This strategy 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 understand the disease and adopt evidence-based measures that improve outcomes.

The bottom line is that receiving early and appropriate treatment would improve the quality of life for thousands of Canadians and their families. Early treatment of Lyme disease reduces the severity and duration of illness. More accurate testing and earlier treatment of Lyme disease would reduce the health care costs associated with a lengthy illness and more severe side effects, particularly for women who suffer long-lasting side effects when their Lyme disease goes untreated.

The New Democrats have been working with Canadians in support of a national strategy on Lyme disease for years now. Now is the time for the federal government to adopt such a strategy to protect the health and safety of Canadians in the face of this rapidly spreading disease.

I urge all members to support the bill.

[Dany Morin, NDP, Chicoutimi—Le Fjord, QC]

Mr. Speaker, it is a pleasure to speak to this bill this evening. As I also have the great privilege of sitting on the Standing Committee on Health, I was able to hear the witnesses and experts discuss the bill when it was referred to the committee and to learn about the improvements that we could make to strengthen it. I also saw that the government had a certain agenda.

At the Standing Committee on Health, we essentially sat down together around the table and agreed that this bill should go forward. Obviously, it cannot necessarily be perfect for everyone, although the NDP will support it. There is a consensus in the Parliament of Canada in 2014 that this bill on Lyme disease is to be taken more seriously.

As many NDP colleagues have mentioned, the tick that carries Lyme disease has been moving northward for many years as a result of global warming. Now we must find ways to protect the people living in southern Canada, and increasingly those further north as well, from this tick, which can have a disastrous impact on people’s lives.

Before discussing the more technical aspect of the subject, I feel that the people who are listening to us at home may not know what Lyme disease is. We talk about a tick, an insect. They may not understand.

My speech this evening will focus essentially on what Lyme disease is and what the tick is. Then I will talk about ways to prevent the disease. I will also talk about my region, Saguenay—Lac-Saint-Jean.

I got lucky last week. An excellent journalist from my hometown, Patricia Rainville, published a very good article on Lyme disease in the local newspaper, Le Quotidien. It will be a pleasure for me to read certain interesting excerpts from it.

The disease was discovered in 1977 in the U.S. town of Lyme, Connecticut, where several children were suffering from arthritis. The disease then gradually spread northward. Cases have been recorded in Quebec since 2011, but numbers have skyrocketed since 2013.

Therefore, we can see that the problem will only get worse for the people of Quebec and of Canada. That is why this is the ideal opportunity for the Parliament of Canada to move forward with a bill on the subject.

Once the tick attaches itself to the skin, it can stay there for approximately 72 hours if it is not detected. Seventy-two hours is the length of time it needs to feed, and during that period it can transmit the bacterium that causes Lyme disease.

A person bitten by a tick carrying the bacterium that causes Lyme disease will develop in the first few weeks a red rash more than 5 cm in diameter around the site of the bite. At that point, the disease can easily be treated with antibiotics. If nothing is done in the following weeks, however, the individual may suffer paralysis, swelling of the limbs, heart palpitations, headaches and even meningitis.

Clearly, the tick that carries Lyme disease can have a serious impact on human health. This is why people ideally should try to avoid being bitten by this tick, which could transmit the disease. To prevent infection, it is recommended that people apply mosquito repellent and wear long clothing and closed footwear before entering high-risk areas. Taking a shower and examining one’s body in the two or three hours following exposure is another excellent suggestion.

This is important, particularly since the tick is more likely to be found in wooded areas. Hunters are obviously at risk when they spend long hours in the woods, which is why many hunters have caught Lyme disease.

Ticks infected with Lyme disease have not yet settled in the Saguenay—Lac-Saint-Jean region, which is a good thing for us. Only one case was reported in the hospitals back home last year, but the disease had not been contracted in my region, thank God. There were no cases of Lyme disease in Quebec five years ago, but the blacklegged tick has come a long way since then.

Today, there are a number of cases of infection in Montérégie. Entomologist Robert Loiselle, whom I greatly admire and know personally, is urging the public to be on the lookout:

I have been talking about this for 15 years. The blacklegged tick was well established in the northern United States, but for the past few years we have been seeing more and more of them in southern Quebec, in Montérégie for example. Tourists who come to enjoy nature have to be extra careful and check themselves after a hike or a walk.

At the Agence régionale de la santé et des services sociaux, spokesperson Éric Émond confirmed that a case of Lyme disease had been reported at a hospital in Lac-Saint-Jean last summer, but the bacteria was not contracted here. This year, as I said, no cases have been reported. Obviously, we never know what will happen if we are not careful.

The Quebec ministry of health and social services is asking the public to be careful. Dr. Danielle Auger, director of public health said:

For the past few years in Quebec, we have observed an increase in the number of ticks carrying the bacteria responsible for Lyme disease. The disease can be contracted from a tick bite during activities in wooded areas, including in higher risk areas in southern Quebec, such as the northern eastern townships, southwestern Mauricie-et-Centre-du-Québec and especially Montérégie, where the majority of cases contracted in Quebec have been reported to date.

According to entomologist Robert Loiselle, it is highly likely that the blacklegged tick could end up in my region:

I recently caught a tick, but upon analysis, it was not carrying Lyme disease. Nevertheless, ticks follow the deer populations. It is therefore not outside the realm of possibility that ticks will show up one day.

I do not want to sound overly dramatic, but even my region, in northeastern Quebec, is not safe from Lyme disease. This is a growing problem, but it is also a national problem. Earlier my colleagues from British Columbia and Nova Scotia discussed the situation in their part of the country. People and health authorities are on alert and are turning to the federal government, as are patients and their families, in the hope that it will do something.

That is truly unfortunate because the Conservative government has put nothing forward for years. The NDP has been proactive in this matter since 2008. NDP member Judy Wasylycia-Leis strongly recommended in 2008 that the minister of health implement a national strategy for the diagnosis, treatment and better monitoring of Lyme disease. Yes, the NDP has been talking about it and making it a priority since 2008. The Conservative government, on the other hand, has been dragging its feet for years. That is why I am grateful that my colleague has introduced this bill. At last we can move forward in 2014.

The official opposition health critic has always recommended that such a strategy be adopted, and she supported Bill C-442 when it was introduced. That is an indication of the NDP's good faith.

The requested strategy should have been adopted long ago. Canadians deserve proper tests and care. The onus is on the federal government to improve monitoring of Lyme disease and to establish best practices so that the provinces can understand the disease and adopt more effective evidence-based measures.

Over the years, the Conservatives have taken no initiatives on important health issues such as the coordination of services provided for chronic and complex health problems and funding for innovative screening and treatment measures. The matter before us is one in which the federal government should show leadership in health care and strive to better protect Canadians.

Many patients in Canada report problems with screening and treatment for Lyme disease. The various blood tests conducted to detect the disease often yield inaccurate results. Patients who have Lyme disease may not be diagnosed with it or may be incorrectly diagnosed with multiple sclerosis or chronic fatigue syndrome. Consequently they do not receive necessary care and, as a result, their symptoms worsen. It is important that we move forward to help these patients.

[Hélène LeBlanc, NDP, LaSalle—Émard, QC]

Mr. Speaker, I am pleased to be speaking after my colleagues, particularly our health and environment critics. Every speech teaches us a little bit more about Lyme disease. I am pleased to also say a few words about Bill C-442, An Act respecting a Federal Framework on Lyme Disease.

I must say that this bill is of interest to me, as are so many other bills. We have heard some stories, and last February I received a letter from a constituent about this bill:

I am one of your constituents and on behalf of the thousands of Canadians suffering from Lyme disease, I am asking you to support Bill C-442 respecting a national strategy on Lyme disease. Debate on the bill begins on March 4.

Later on in the letter, she wrote:

We need to support Bill C-442 so that we can develop a national strategy to fight this serious disease.

The person who wrote me asked me to meet with her, which is what I did. The meeting was truly amazing for me. I was there with the mother of someone with Lyme disease.

She told me about the ordeal that she and her child, now an adult, had to go through before getting a diagnosis. Finally, after several years, it was discovered that this person was afflicted with this terrible disease. The child experienced a number of symptoms, got several diagnoses, and underwent numerous tests before being accurately diagnosed. Despite numerous doctors’ appointments and hospital tests, they were faced with more questions than answers. Over this time, the disease took its toll, and became chronic. This person will have to live with the chronic symptoms of Lyme disease.

Finally, thanks to a test in the United States—not in Canada—a clear diagnosis was obtained. In spite of the trials and tribulations, and an established diagnosis, the parents told me that it was actually a relief for the person with the disease to know what the diagnosis was. Indeed, once the disease becomes chronic, many of the symptoms of Lyme disease closely resemble chronic fatigue syndrome.

What happens when a person has symptoms but no clear diagnosis? Often, those afflicted get depressed because they do not know what has caused the symptoms. Their family and friends are left wondering what to do. They do not know how to help people with the fuzzy diagnosis of chronic fatigue syndrome. When a diagnosis was established in this case, the family was able to support the person with Lyme disease and at that point they could come together to develop a plan of action as to how to cope with the disease.

The parent in question also praised the Canadian Lyme Disease Foundation, commonly known as CanLyme. The Foundation carries out very important work to raise awareness about the symptoms, diagnoses and ways to prevent Lyme disease. CanLyme is also a not-for-profit organization, and its website contains a great deal of information dispelling a number of myths and misconceptions around the disease.

I would like to commend the foundation on its extraordinary work. I would also like to salute the courage of this parent who came to meet with me to talk about their story and the plight of their loved one with Lyme disease, who had to go through quite an ordeal before getting a diagnosis.

The bill calls on the government to develop a national strategy to combat Lyme disease. I think that the government has to understand not only the need to put a strategy in place, but also the need for resources and financial backing. Parks Canada needs tools to advise people visiting our national parks on how to recognize the infamous insect that infects people with Lyme disease and the steps they should take if they are bitten, to ensure that the illness does not become chronic.

If it can be done for poison ivy, I do not understand why it cannot be done for Lyme disease. Moreover, a national strategy would help us work together with the provinces to develop tools to prevent this disease.

It is important to understand what is happening. Why is this disease spreading? It was previously a little known disease because it did not occur in Canada, where many insects die in our frigid winters and therefore do not cause a problem. However, climate change and global warming are having an effect on us as a Nordic country.

I am an agronomist by training. I got my training not so long ago. In class, we were told that Canada needed to adapt to changes in agriculture and prevent diseases that will emerge as insects head a little further north. The government must tackle these problems head on.

That is why the An Act respecting a Federal Framework on Lyme Disease is a step in the right direction, and that is why I support it. I also support it on behalf of a parent who came to meet me in my office to tell me about Lyme disease and make me more aware of it.

[Libby Davies, NDP, Vancouver East, BC]

Mr. Speaker, I am pleased to rise in the House today to speak in support of third reading of Bill C-442 for a national framework for Lyme disease.

Today is a special day. It is not every private member's bill that gets to third reading. The fact that this bill has means that it has stood the test. It has gone through the challenges of going through second reading, going to committee, through amendments, and here it is back in the House. We are anticipating and hopeful that the bill will be approved today in the House of Commons and then go to the Senate.

I would like to speak briefly to the bill, but I would first like to congratulate the member for Saanich—Gulf Islands for the hard work that she has put into this bill, into building alliances and talking to people in different parties. It is a good example of the goodwill and the solidarity that can develop around an issue when people recognize that something needs to be done. I only wish it would happen more often in the House. There are so many issues that need our attention, collectively, with a spirit of fair play and goodwill. Maybe this bill will be a good model for that, but I wish it would happen a little more often.

When this bill came to the health committee, I was pleased to be there. We went through it and heard witnesses. Hearing the witnesses was incredibly compelling. We heard from Jim Wilson of the Canadian Lyme Disease Foundation. People shared personal experiences about this disease, which is not easy to do in a formalized parliamentary hearing as a witness with all of the official trappings that go along with that.

Chris Powell and her daughter Nicole were quite remarkable. Nicole, who is from British Columbia, was quite remarkable in sharing her experience of having Lyme disease and the suffering she was going through. It is not only physical suffering, which she still endures, but also the emotional anguish of not being able to get a proper diagnosis.

One of the critical elements of the bill is that it would bring together the different elements we need in terms of not only prevention and better public awareness, but a medical community that is in a much more heightened state of awareness with respect to Lyme disease, as well as better clinical diagnostic tools and testing.

We heard horrifying stories from people who had gone to extraordinary lengths to find out why they were so sick and why they could not get help. We know there are two tests available in Canada, but they pertain only to basically one strain of the tick that produces Lyme disease. There is so much that needs to be known.

We heard stories about the amount of money people had spent to go to the United States, for example, where other testing has been available, to finally get a correct diagnosis. Then they would come back to Canada and have somebody contradict that diagnosis. It a nightmare for these people to live through, not just enduring and living with the disease, but coping with systemic barriers and obstacles to proper diagnosis and get the treatment they need. We heard all of that at committee. It was compelling and it made us all acutely understand that we needed a national framework.

I want to spend a moment on that. As the health critic, I meet with many organizations across the country, in Ottawa, in my riding and elsewhere. There are so many issues and people are literally begging the federal government to show leadership to develop a national strategy, whether for dementia or Alzheimer's. This is just another example of that. It is a reflection of our complex system.

We know that health care is a provincial delivery system. There is no question about that. However, there is a necessity for federal leadership. Under the Canada Health Act, we have a duty and responsibility to ensure that all people in our country, whether rich or poor or whether they live in the north, south, east, west or the centre, in small communities or large urban centres, have accessibility to our health care system. We know the inequities are getting greater, and not just between provinces but also within provinces.

There is an overarching issue that the bill also reflects, which is that we need to see the federal government be at the table. We need to see the federal government take leadership on these issues. Many groups are calling for a national strategy. People know the reality of this kind of scattered approach. It is like a patchwork across the country and that just is not good enough.

The bill speaks about a federal framework and would bring together the players. As the member for Saanich—Gulf Islands has outlined, a key element of the bill is to convene a conference and include people who have Lyme disease and advocates so they are at the table as well. It is really about trying to bring the players together to develop that national framework.

We also heard at committee very interesting testimony from representatives of the Public Health Agency of Canada. They told us that Lyme disease had been a reportable disease only since 2009. We are only beginning to get a sense of the numbers out there. Of course many cases are not reported. Either people do not know they have the disease or if they suspect it, they do not get a proper diagnosis.

I agree with the member that we will face an explosion of cases, particularly with climate change and a warming environment. In southern Canada and places like B.C., where we really have not seen that many cases of Lyme disease, this will be on the increase.

I was very interested to hear that the Public Health Agency of Canada was conducting a fairly major public awareness campaign. In fact, the people from the agency assured us that Lyme disease should be a household word by the end of summer. People would know what it was, what they needed to be aware of and what they should do. I hope they are right because we do not want to see anybody suffer through this.

The issue of testing is very important. We heard loud and clear that there was an inadequate testing procedure in Canada. We need to have much better availability of testing with a greater depth of testing for different kinds of bacteria and strains.

Then finally on research, the Canadian Institutes of Health Research told us that some very good research was going on in Canada. I believe one of the researchers was in Calgary and another was maybe in Ontario. We need to fund that research. We need to know about the different strains so people can receive the appropriate diagnostic analysis and treatment.

The New Democrats have been very happy to support this bill all the way through. We are critically aware of this issue. It is something we speak about with our constituents. I am sure many of us have had visits from our constituents who have been affected by Lyme disease.

At the end of the day, we owe gratitude and thanks to the Lyme disease Foundation of Canada, which has done incredible work on this and has never given up. It is not easy. We have resources here. We can bring forward a private member's bill, which I do not want to diminish as it has a very important part. However, what is really wonderful is the fact that the people in the community, those who themselves are suffering, pushed this boulder uphill. They did not give up and they compelled us as legislators to take on this issue and support it.

Finally thanks go to those advocates. We need to remain vigilant and monitor what goes on to ensure this framework becomes a strategy that will help people.

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

Mr. Speaker, I am glad that the hon. member for Vancouver East took a moment or two to put the question so that I could pull myself together. I am quite overwhelmed and very grateful.

I appreciate that there were changes made at committee. I do not believe that they take anything away from the thrust of the bill, but as with any piece of legislation, we will have to remain vigilant.

I know that the current Minister of Health is very committed to this, but the bill will require initiatives from the Minister of Health to hold a conference. That conference will gather expertise from the health and medical community and the Lyme disease patient community and, of course, engage at some level the federal, provincial, and territorial ministers for health.

One amendment changed that process from a six-month mandatory window from the point of passage to twelve months in order to incorporate and provide flexibility for the fact that Bill C-442 would mandate ministerial consultations at a very significant level.

We just have to commit that there is goodwill here. There is an intention to make a difference for people. We have all learned a great deal from the Lyme disease patient community. There are people whose lives have been cut short. They cannot do the job they used to do.

One of the most heartbreaking cases in my own riding is that of a young man who wrote to me and who I saw on Boxing Day. He had not been well enough to come down the corridor on Christmas morning to watch his girls open up their Christmas presents.

The sense of urgency is with us. In the spirit of goodwill, we will monitor this bill and keep pushing in a friendly fashion. We will not let the bill just sit on a shelf. I believe that is the motivation of the Minister of Health, as it is for my hon. colleague, the official opposition health critic.

The House proceeded to the consideration of Bill C-442, an act respecting a federal framework on Lyme disease, as reported (with amendments) from the committee.

Concurrence in Vote 1--Senate

[Michelle Rempel, Conservative, Calgary Centre-North, AB]

Mr. Speaker, going back to this particular example, my colleague from Saanich—Gulf Islands introduced this legislation in the House in accordance with the precedents set on private members' bills. I believe the bill is coming up for debate shortly.

The bill will be debated here at second reading stage and will go to committee. Many of the stakeholders that my colleague has consulted on the bill will provide their input at committee stage. I hope that we have great debate on this particular bill. Should the bill be supported in the House, where would it go to become law? What is the next step in this process?

If we go back to what I just went through, which is publicly available and part of any civics lesson, the bill will go to the Senate for the next stage of review, and then royal assent. That is how the legislative process in Canada works. In order for Bill C-442 to become law, the Senate needs to be funded in order to pass it.

Not putting this vote forward in the estimates means that the NDP is voting to shut down the legislative process in this country. It is as simple as that.

We can have an extensive debate on Senate reform and how senators should be elected and so on, but that is not the subject of the debate tonight. The NDP has proposed to shut down the legislative process in Canada. For all of the democratic woe is us, for all of the democracy in Canada is this and that and what not, we have before us a suggestion to shut down the legislative process in Canada.

We are late in the session. Many of us want to be in our ridings connecting with our constituents. We should all give pause for thought as to what that means. It means that if legislation from the House cannot be passed, then it cannot be enacted. It means that next year, the routine process of government that goes through the Senate would not happen. Whether one agrees with Senate reform or abolition or however a member thinks we should seek to change it, the reality remains that not voting this particular piece forward means we cannot put government legislation through.

I have been listening to the questions and answers tonight. We have had a lively debate on how we could possibly make the Senate more accountable to Canadians; that is subject matter worthy of debate, but it is not the substance of what is being debated right now. Sometimes we lose sight of that.

I would ask my colleagues across the way just to have a think. The NDP has put forward a few private members' bills over the years, not just in this session, that have achieved consensus in the House. How do they become law? They become law by going through the Senate. This is part of Canada's Constitution.

The vote on the estimates that has been put forward here is for this upcoming fiscal year. Our government asked for a Supreme Court opinion on what we could and could not do in the House in terms of scope for Senate reform. We were obviously quite disappointed with the outcome of that decision. That said, my colleague the Minister of State for Democratic Reform has talked about how we as a government will press forward on this particular issue because it is something of concern to Canadians. We also have to look at this upcoming fiscal year, which is the subject matter of the estimates.

I would like to see government continue to operate because I would like to see legislation continue to go through the House. I hope that my colleagues will give pause for thought on this one and support Vote 1, because the reality is that this is part of Canada's Constitution. We need to separate the debate around how we could reform the Senate, which again is worthy of debate, from the reality of this particular motion.

I could go through numerous bills in terms of how this particular vote would affect them. The Senate right now has a very heavy legislative calendar. Many of the committees are tasked with a review of bills that have come from here.

Certainly my colleagues opposite would say that there is support for some or all components of some of these bills. I would like to see those bills passed. I would like to see that process continue to operate, which is why we support Vote 1 in the estimates. It is because constitutionally we need the Senate to operate in order for legislation to be passed.

It is very short-sighted for us as a House to sit here and say we cannot fund the Senate and that we are going to pull the funding from it. How, constitutionally, would we put legislation through? I just do not understand this. It is actually a little mind-blowing that the substance of this situation has not come up. Constitutionally, the Senate has to operate. Certainly in the next fiscal year, even if we work at lightspeed beyond the speed of government, the Senate has a job to do right now, and certainly we would all say that we should continue to support it.

Because the topic of Senate reform has come up in debate tonight, I would like to take this opportunity, because I have been itching to do so for a few months, to talk about the approach to Senate reform of my colleagues in the Liberal Party. I find it a bit disingenuous for the senators who consider themselves Liberals in their caucus to all of a sudden walk out and say that they are not Liberals anymore.

[Michelle Rempel, Conservative, Minister of State (Western Economic Diversification)]

Mr. Speaker, it is a pleasure to address the House and anyone who might be in the gallery tonight on a beautiful summer evening in Ottawa.

We need to be clear on what we are talking about tonight, what the substance of the debate is. It is my understanding that my colleague from Winnipeg Centre gave notice of opposition to Vote 1 in the estimates, which is an amount of approximately $57 million under “The Senate—Program expenditures, in the Main Estimates for the fiscal year ending March 31, 2015”.

What does this mean? It means that this amount is part of the amount that the Senate uses to conduct its operations. There has been a lot of important debate tonight about changes in the Senate, about how we could reform the Senate, about how the Senate could act in a more transparent manner or be more accountable to Canadians. These are important, weighty issues.

I have certainly been quoted in the media. My opinions about the need for Senate reform are on the public record. When I go out to talk to my constituents, it is an issue. How do we make the folks who are responsible for legislation in this country more accountable to Canadians? There are several senators who would agree that this body should be made more accountable. This is a topic of debate.

Going back to what we are talking about tonight, it is the allocation for this upcoming fiscal year for the operations of the Senate. I am going to take a moment, because I have some time tonight, to read an article that is on the Parliament of Canada website. It is entitled “Making Canada's Laws”. It states:

...Canada's Constitution states that both the Senate and the House of Commons must approve bills separately in order for them to become law. Legislative basics The lawmaking process starts with a bill — a proposal to create a new law, or to change an existing one. Most of the bills considered by Parliament are public bills, meaning they concern matters of public policy such as taxes and spending, health and other social programs, defence and the environment. A bill can be introduced in the House of Commons (C-bills) or the Senate (S-bills), but most public bills get their start in the Commons. A bill goes through certain formal stages in each house. These stages include a series of three readings during which parliamentarians debate the bill. Prior to third and final reading, each house also sends the bill to a committee where members examine the fine points of the legislation. Committee members listen to witnesses give their opinions on the bill, and then subject it to clause-by-clause study based on the testimony. Either house can do four things with a bill: pass it; amend it; delay it; or defeat it. Sometimes, one house refuses changes or amendments made by the other, but they usually both agree eventually. All laws of Canada are formally enacted by the Sovereign, by and with the advice and consent of the Senate and the House of Commons. Once both houses have approved a bill, it is presented for Royal Assent and becomes law.

Just to recap, how does a bill become law? It passes through the first House—sometimes the Senate, but usually the House of Commons—and it passes through the second House—usually the Senate, but sometimes the House of Commons—and then royal assent is given by the Governor General.

How does it pass through a House? It goes through first reading, when the bill proposing a law is received and circulated. At second reading, the principle of the bill is debated to verify that the bill represents good policy, et cetera. Then it goes through committee stage. Members of the public appear as witnesses to comment. At report stage, the committee report is considered by the whole House. Third reading is final approval of the bill, and the bill is either sent back to the other House or set aside for royal assent.

As a recap on how the legislative process works here, right now, for this fiscal year, we require both Houses in order to pass legislation. I actually do not think anyone here can argue that, and if they do, they need to have a refresher course prior to continuing their activities in the House. We need to have both sides under our Constitution right now.

The subject of the debate tonight is whether we should or should not approve funding for the upcoming fiscal year to keep the government operational. To put this in a real-life context, there is opposition on this particular vote. If this vote in the estimates were to be defeated, what would that mean in a real-life context?

A bill is coming up that my colleague from Saanich—Gulf Islands is keen on, because she proposed it. I am talking of Bill C-442, an act respecting a national Lyme disease strategy. It had first reading in the House on June 21, 2012, according—

Business of the House

[Peter Van Loan, Conservative, Leader of the Government in the House of Commons]

Mr. Speaker, I will start with the concept of the very strange proposition put forward by my friend. He uses this concept of shifts and believes there is some perverse obligation on the part of the government that, if the opposition wishes to filibuster the production of new laws and delay their production, we somehow have an obligation to match them step for step in extending that process. His comparison is with ordinary Canadians. He said that ordinary Canadians should not produce a product at the end of the day at work; they should take two, three, or four days to get the same thing made. That is his idea of getting things done. That is his idea of how ordinary Canadians can work. I think that says something about the culture of the NDP and the hon. member. I will let members guess what culture that is. It is a culture that does say we should take two or three times longer to get something done or to get to our destination than we possibly can.

We on this side are happy to make decisions to get things done for Canadians. In fact, that is exactly what we have been doing. Since I last rose in response to a Thursday question, the House has accomplished a lot, thanks to our government's plan to work a little overtime this spring.

I know the House leader of the official opposition boasts that the New Democrats are happy to work hard, but let us take a look at what his party's deputy leader had to say on CTV last night. The hon. member for Halifax was asked why the NDP agreed to work until midnight. She confessed, “We didn't agree to do it.” She then lamented, “We are going from topic to topic. We are doing votes. We are at committees. They are really intense days. We're sitting until midnight.”

On that part, I could not agree more with the deputy leader of the NDP, believe it or not, but with much more cheer in my voice when I say those words, because we think it is a good thing. These are intense days. We are actually getting things done. We are actually voting on things. We are actually getting things through committee. For once, we are going from topic to topic in the run of the day.

Let me review for the House just how many topics, votes, and committee accomplishments we have addressed since the government asked the House to roll up its sleeves.

Bill C-24, the strengthening Canadian citizenship act, was passed at second reading and has even been reported back from the citizenship committee.

Bill C-10, the tackling contraband tobacco act, was concurred in at report stage and later passed at third reading.

Bill C-31, the economic action plan 2014 act, no. 1, was reported back from the finance committee.

Bill C-27, the veterans hiring act, was passed at second reading.

Bill C-20, the Canada-Honduras economic growth and prosperity act, was concurred in at report stage.

On the private members' business front we saw:

Bill C-555, from the hon. members for West Nova in support of the seal hunt, was passed at second reading.

Bill C-483, from my hon. colleague, the member for Oxford, cracking down on prisoners' escorted temporary absences was passed at third reading.

Bill C-479, from the hon. member for Ancaster—Dundas—Flamborough—Westdale, on improving the place of victims in our justice system was passed at third reading last night.

Progress is not limited to Conservative initiatives. The Green Party leader's Bill C-442, respecting a Lyme disease strategy, was reported back from committee yesterday.

The hon. member for Timmins—James Bay saw a motion on palliative care pass.

We have also seen countless reports from committees reviewing the government's spending plans, as well as topics of importance to those committees.

This morning we even ratified the appointment of an officer of Parliament.

Finally, I do want to reflect on the accomplishment of Bill C-17, the protecting Canadians from unsafe drugs act (Vanessa's law), which members may recall me discussing in last week's Thursday statement. It finally passed at second reading. However, this did not happen until the NDP relented and changed its tune to allow the bill to go to committee. It was the first time ever that we had an expression from the New Democrats when we gave notice of intention to allocate time in which they said, “We don't need that time; we're actually prepared to allow a bill to advance to the next stage”. I think, by reflecting on the fact that those dozens of other times the NDP did not take that step, we could understand that they did not want to see a bill advance; they did not want to see progress made. That lets Canadians understand quite clearly why it is we need to use scheduling and time allocation as a device to get things done in the face of a group that thinks the objective is to fill up all possible time available with words rather than actual votes and getting things done.

It is clear that our approach is working. We are getting things done in the House of Commons and delivering results for Canadians.

Perhaps I might be overly inspired by the example of Vanessa’s Law, but I do want to draw the attention of the House to Bill C-32, the Victims Bill of Rights Act.

So far, we have seen three days of debate on second reading of the bill, but “debate” is actually not accurate. What we have witnessed is speech, after speech, after speech—most of them from New Democrats—offering platitudes of support for the idea of getting that bill to a committee where it could be studied. What I want to know is, why will they not just let it happen? Victims of crime want to see meaningful action, not just kind words.

Suffice it to say that I will need to schedule additional time for discussion of this bill. Perhaps the NDP will let it pass after a fourth day of talk.

This afternoon, we will continue with the report stage debate on Bill C-31, our budget implementation bill. When that concludes, we will turn to Bill C-20, to implement our free trade agreement with Honduras, at third reading. If time permits, we will continue the third reading debate on Bill C-3, the Safeguarding Canada's Seas and Skies Act.

Tomorrow morning, we will start the report stage debate on Bill C-24, which makes the first modernization of the Citizenship Act in 35 years. After question period, I will call Bill C-32, the Victims Bill of Rights Act, to see if the NDP is ready to deliver results, not talk.

Monday morning, we will continue the third reading debate on Bill C-20, if more time is needed, and then resume the second reading debate on Bill C-18, the Agricultural Growth Act. After question period, we will get back to the Strengthening Canadian Citizenship Act.

Tuesday shall be the eighth allotted day when the NDP will have a chance to talk, and talk, about a topic of their own choosing. At the end of the night, we will have a number of important votes on approving the funds required for government programs and services and pass two bills to that end.

On Wednesday, we will debate our budget bill at third reading, and then we will start the second reading debate on Bill C-36, the Protection of Communities and Exploited Persons Act, which my seatmate, the Minister of Justice, tabled yesterday.

We will continue the debates on Bill C-36 and Bill C-24, if extra time is needed, on Thursday. After those have finished, and on Friday, we will resume the uncompleted debates on Bill C-3, the Safeguarding Canada's Seas and Skies Act, at third reading; Bill C-6, the Prohibiting Cluster Munitions Act, at report stage; Bill C-8, the Combating Counterfeit Products Act, at third reading; Bill C-18, the Agricultural Growth Act, at second reading; Bill C-26, the Tougher Penalties for Child Predators Act, at second reading; Bill C-32, the Victims Bill of Rights Act, at second reading; and Bill C-35, the Justice for Animals in Service Act (Quanto's Law), at second reading.

To make a long story short, we have accomplished much in the House over the last week, but we still have much left to do, which inspires me to note that in the week ahead I have to take my automobile in for maintenance. At that time, when I take it to the dealership, I hope one person will work on it for an hour, get the job done, and then return it to me at a reasonable cost. I do hope I am not told, “There are still many more employees who have not had a chance to have a shift working on your car as well, so we are going to keep it here another three days and give everybody a turn to work on your car.” I hope the dealership will do as Conservatives do: get the job done and then deliver me the product.

Health

[Ben Lobb, Conservative, Huron—Bruce, ON]

Mr. Speaker, I have the honour to present, in both official languages, the fourth report of the Standing Committee on Health in relation to Bill C-442, An Act respecting a National Lyme Disease Strategy. The committee has studied the bill and has decided to report the bill back to the House with amendments.

[The Chair, Conservative, Ben Lobb]

That covers what we needed to do, and we're five minutes ahead of our plan, so we'll consider Bill C-442 dealt with and we'll report it back in due course.

Ms. May has a short comment, and then we're going to go in camera.

Go ahead.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Mr. Chair, we move that Bill C-442 in clause 3 be amended by (a) replacing lines 12 to 14 on page 3 with the following:

3. The Minister must, no later than 12 months after the day on which this Act comes into force, convene a conference or otherwise engage with the provincial and territorial ministers and

And (b) replacing line 18 on page 3 with the following:

federal framework that includes

And (c) replacing line 21 on page 3 with the following:the Agency to

And (d) replacing lines 26 to 29 on page 3 with the following:management of Lyme disease, and the sharing of best practices throughout Canada;

And (e) replacing, in the French version, lines 6 and 7 on page 4 with the following:

nationale et d'en améliorer la prévention, l'identification, le traitement et la gestion.

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

I have one last question to you before I turn to Dr. Ouellette.

Having looked at Bill C-442, I don't think any bill is perfect at first reading. Are there things in it that you'd like to see improved that are not currently before us in government-recommended amendments?

[Steven Sternthal, Acting Director General, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Infectious Diseases Prevention and Control Branch, Public Health Agency of Canada]

Good morning.

Thank you, Mr. Chair and members of the committee, for the opportunity to contribute to your deliberations on Bill C-442.

I am pleased to be here today to address the work under way in the Public Health Agency of Canada to reduce Lyme disease across the country.

I'll begin by addressing the agency's role and how it applies to Lyme disease.

The agency aims to promote better overall health of Canadians by preventing and controlling infectious diseases. We undertake primary public health functions, such as health promotion, surveillance, and risk assessment. These inform evidence-based approaches to prevent and control the spread of infectious diseases.

As part of its public health leadership role, the agency coordinates the national surveillance on Lyme disease as one of the most rapidly emerging infectious diseases in North America. I know that was part of your deliberations late last week.

The spread of Lyme disease is driven, in part, by climate change, as the tick vector spreads northwards from endemic areas of the United States. Moving into Canada, it is impacting our most densely populated regions. Based on the lessons learned in the United States, we anticipate the disease will affect over 10,000 Canadians per year by the 2020s.

To date, we have seen cases increase from 128, in 2009, when Lyme disease became a nationally notifiable disease, to an estimate of over 500, in 2013. That's a fourfold increase in just over five years.

However, this national snapshot only reflects a portion of all cases in Canada. This is because some people do not seek treatment for milder symptoms. Others do seek medical help, but may be misdiagnosed because their doctors are not always aware of the range of symptoms, or even that Lyme disease is in Canada. Agency risk models estimate the true number of infections to be at least three times higher than what has been reported today.

To support physicians in diagnosing Lyme disease, laboratory diagnostic testing is available across Canada in various public health laboratories. Like the United States, we use a two-tier test that must be requisitioned by a physician: the ELISA, to screen; and the western blot, to confirm Lyme disease.

The following are just a few facts about the testing in Canada.

Last year, almost 40,000 ELISA tests were administered by provincial and national laboratories. Of this total, approximately 3,000 tested positive or inconclusive, and were sent on to have essentially the second part of the screening and testing, the western blot, for confirmation of Lyme disease, by either our National Microbiology Laboratory in Winnipeg, or by public health laboratories in Ontario and British Columbia.

Following a thorough review of this surveillance information, available domestic and international research, stakeholder views, and existing public health messaging on this important topic, the agency has put in place an action plan to prevent and control Lyme disease in Canada. The action plan identifies three pillars for concrete action: engagement, education, and awareness; surveillance, prevention, and control; and research and diagnosis.

The first pillar includes a comprehensive public awareness plan that focuses on educating health care professionals and the public about Lyme disease.

Raising awareness among health professionals is one of our main goals: informing them that Lyme disease is here, educating them on symptoms, and encouraging them to properly diagnose and report cases.

This year, we have already reached an estimated 200,000 health professionals with awareness posters published in medical journals beginning in March. We have also presented to clinicians at a variety of venues across Canada in recent months.

We are also using every means available to get the message out to the general public. From social media, to Google AdWords, to partnering with organizations like The Weather Network, we are telling Canadians that Lyme disease is here, how to recognize it, and how to protect themselves from it. These public messages will continue throughout the summer period, which really is the Lyme disease season in Canada.

The agency has also worked with provincial and territorial public health authorities, as part of the Pan-Canadian Public Health Network, to develop a coordinated, vector-borne disease communications strategy, and public awareness tools targeting Lyme disease.

We hope that by the end of this year's tick season Lyme disease will be a household term.

I would now like to address the second pillar, which focuses on innovative ways to conduct surveillance and encourage preventive behaviour.

Efforts made in Lyme disease surveillance are starting to show some results. This year the majority of provinces are providing detailed case information, which will help identify new areas where Lyme disease is endemic and assist provinces in tailoring their preventive strategies.

The information will also provide a clear picture of the signs and symptoms of Lyme disease, information that is key for clinicians to properly diagnose it.

The final pillar focuses on increasing lab capacity, testing new diagnostic methods and carrying out research to generate new insights into effective diagnosis and treatment.

Under this pillar the agency is increasing testing capacity and quality by using state-of-the-art laboratory equipment. We recognize the challenges with current testing, particularly around detecting early Lyme disease, as the human body takes some time to develop antibodies to the bacteria.

The agency is committed to improving diagnostic testing. New methods are being evaluated and any that outperform current methods, the two-step method, will of course be adopted.

In the meantime we continue to recommend doctors diagnose patients on the basis of a full, wholesome, clinical assessment.

We recognize that laboratory technologies have evolved and will continue to do so in the future. The agency's national microbiology laboratory, in collaboration with the Canadian Public Health Laboratory Network and other stakeholders, will be updating our laboratory diagnostic guidelines in the near future.

However in doing so the agency faces a challenge. We can update the guidelines to reflect the current available evidence, but new evidence is needed to inform new diagnostic and new treatment methods. Therefore the agency is committed to continuing to work with medical professionals, patient advocacy groups such as the Canadian Lyme Disease Foundation and the Canadian Institutes of Health Research, and my colleagues on the video conference today to identify and address research gaps.

In closing, I would like to restate that the goal of the agency is to mitigate the impact of Lyme disease on Canadians. Through our collective efforts, Canadians will become more aware of the disease, how to recognize its symptoms, and the benefits from early treatment.

Together, we can reduce the severity of Lyme disease in Canada.

Thank you for your attention.

[The Chair, Conservative, Ben Lobb]

Good morning, ladies and gentlemen. Welcome back.

We're studying Bill C-442 in our final meeting on it. We're going to get right at it. We have two witnesses here today. We have the Institute of Infection and Immunity. There were a few problems with the connection but we are connected now. So we're going to go right ahead with Mr. Ouellette.

You have 10 minutes for your presentation. We'll just carry on. Can you hear us okay, sir?

Lyme Disease

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

Mr. Speaker, I rise to present two petitions. I am extraordinarily heartened to present over a thousand names of Canadians from coast to coast in support, as are all the parties in the House of Commons, of Bill C-442, an act to create a national strategy on Lyme disease. Thousands of Canadians are asking for our help.

Earlier this morning in the health committee I spoke to this. We have such strong support from across the country and around the House, so let us get on with it.

[The Chair, Conservative, Ben Lobb]

Thanks very much.

Unfortunately, we've come to the end of our two hours. This will conclude our first meeting on Bill C-442. I look forward to seeing everybody else here on Tuesday.

Thank you again to our guests for taking the time to be here and for providing your information.

Thank you. This meeting is adjourned.

[Jim Wilson]

CanLyme supports Bill C-442, and our preference is that the wording not be changed to reflect best practices over standard of care. The term best practices has been used far too many times to justify the wrong directions.

Besides, what purpose does the term best practices serve other than to make a claim of excellence and highest standards? History shows us the term was used to hide behind or to ignore contradictory research and opinion. Do we need that again? Ask yourself why.

Thank you.

[Jim Wilson, President, CanLyme]

Thank you, everybody. Thank you for giving the Canadian Lyme Disease Foundation this opportunity to speak before you today on this very important issue.

Thank you, Elizabeth May, for putting this important bill forward.

Bill C-442 is a very important first step toward developing a made-in-Canada solution to a very serious illness now affecting Canadians in the thousands. Lyme disease is a bacterial infection caused by a spiral-shaped organism called Borrelia, and we have many strains of Borrelia in Canada and North America. Therefore, Lyme disease is a Borreliosis.

The first case was confirmed in Canada in Ontario in 1977. Here we are in 2014, almost 40 years later, and we still do not have a good definition of what Lyme disease is. Tens of thousands of Canadians have been tested for suspected Lyme over the past decades and have been wrongly told they didn't have Lyme, based on a test that cannot look at all strains of Borrelia. Yet all research and testing has stemmed from only that one strain that is recognized in the current testing model. To date, it is that poor test that has defined what Lyme disease is.

It's been known for decades that we have multiple strains. They are not new, and more strains are still being discovered as technology improves. The Public Health Agency of Canada recently published a paper showing that we have a strain of Borrelia called miyamotoi, and we have that coast to coast. There currently is no human blood test for that particular strain of Borrelia that causes Lyme disease.

In reality, Canada has no idea how much Lyme disease is in our chronically ill population. An entire set of guidelines was created in the United States that revolved around that one strain, to the exclusion of all other strains. The U.S. guidelines were adopted overnight in Canada without any discussion except within a small group of individuals from within government and the infectious disease community, who were also in regular contact with that small group of their peers in the United States who created the now infamous guidelines.

We patients and our experts were excluded from those discussions despite our years of repeated requests to be involved. As a result, our hard questions were never considered and never heard. As a result, we have a much larger problem on our hands now.

The first Lyme society was formed in B.C. in 1989 by Diane Kindree. Another was formed the next year in 1990 in Ontario by John Scott, a researcher who has now since published many papers on Lyme disease, its genetic diversity, and how it is transplanted randomly in vast numbers by transplanting the ticks via migratory birds, both on the north-south migratory flyways and the east-west migratory flyways.

Since then, the victims of Lyme disease have been connecting with scientists and physicians around the globe, developing a great deal of expertise. We've pointed out many times since then that testing was flawed and that many Canadians were falling through the cracks—or actually, falling through the gaping holes.

It has come to our attention that there is this amendment to the wording of Bill C-442 changing the term “standard of care” to “best practices”. As soon as Lyme patients from across Canada heard that mentioned on television, we got inundated with calls and e-mails from patients. That term terrifies patients. Many years ago, without giving a fair hearing to the patients and their experts, those poorly contrived, narrowly focused guidelines were imposed and from that point forward were referred to as “best practices”.

People with Lyme disease became not only the victims of the disease, but they became the victims of best practices. The term best practices became the phrase most used in media and literature to simply quiet the discussion, as though some all-knowing group had everything under control. They did not, and we have a huge and growing problem in Canada and around the world. The U.S. government announced last summer that they had been underestimating the number of cases of Lyme disease: instead of 30,000 cases a year, there are 300,000 cases per year.

Patients were too lowly to be listened to, despite our warnings since the early nineties. In one letter sent to us here at CanLyme from the Public Health Agency of Canada, in response to our request to be at the table for policy and guideline discussions, we were told we were just an advocacy group, end of story.

We pointed out that we had expertise in all the necessary fields of science and medicine at our fingertips, and that we had a great deal to offer; still nothing.

We pointed out that we had a vested interest in what they were deciding, as we represent the most significant and important stakeholder—the victim—whose life is directly affected by what they decide; still nothing.

Best practices continued to be imposed upon the system, yet there was no diversity of opinion allowed in their creation. Diversity of opinion is the foundation of a healthy society.

Best practices for Lyme are currently wrong on many levels, yet any physician who dares operate outside of these best practices is immediately targeted and sanctioned. Less than 2% of all physicians are investigated because of their practices, yet almost 100% of physicians in Canada who dared use their best judgment on Lyme issues and not followed the poor best practices have been effectively shut down. The complaints in almost 100% of these cases against the doctors did not come from patients; they came from specialists who did not like their initial diagnoses being questioned. The complaints were specifically that the doctors were currently not following best practices.

Best practices currently trivialize the many symptoms caused by Lyme disease, labelling them in writing as the aches and pains of daily living.

These so-called aches and pains of daily living have been causing people to no longer be able to work or go to school. These aches and pains of daily living have been putting people in wheelchairs, continuing to confine them to bed, or, in an unknown number of cases, causing death.

These are hardly the aches and pains of daily living.

Best practices ignore the fact that thousands of Canadians have been misdiagnosed with having everything from multiple sclerosis, Alzheimer's disease, Parkinsonism, Lou Gehrig's disease, lupus, chronic fatigue syndrome, fibromyalgia, psychiatric disorders, various forms of arthritis, and many more, only to find out later it was treatable, chronic Lyme disease all along.

Best practices have allowed inadequate level-3 evidence to guide health care, when only level-1 evidence should be allowed where lives and health are at stake. Best practices have denied treatment for chronic Lyme disease because the best practice states there is no such thing as chronic Lyme disease.

Each committee member will be receiving a compilation of references to over 300 published papers that show quite convincingly that chronic, active, persistent Lyme disease, beyond short rounds of antibiotics, is very real. Best practices ignore and dismiss this body of research; no discussion allowed. Instead, they made up a name for symptoms after short-term antibiotics, calling them “post-treatment Lyme disease syndrome”, a term for which there is no research to support; no discussion allowed.

We haven't even identified what Lyme disease is yet, and we have not explored all the various strains of Borrelia for their response to treatment and for their broad symptomatology. Yet we have best practices in place and enforced.

Physicians refuse to diagnose and treat Lyme disease regularly by claiming they follow best practices. Tens of thousands of people who chose to ignore best practices now have their life back, including me and my daughter. My son didn't make it, though. He passed away in 2005. I contracted Lyme disease in 1991 in Dartmouth, Nova Scotia. My children contracted their infection in B.C. a decade later, along with other kids in our area, another of whom is deceased as well.

If this committee recommends the change of wording from “standard of care“ to “best practices“, we believe it must be made clear in the wording that there can be no best practices put in place without full participation and approval of the victims and their chosen experts. We cannot continue to allow the current autocratic system to further erode what should be a common-sense democratic process of evidence-based health care. That demands a diversity of opinion.

Bill C-442 is only a start, but it can be the hand that opens the door to a new era of cooperation and discussion. If we simply use the term best practices without open discussion and all-inclusiveness, then that door will quickly close again.

According to Health Canada, we have two million Canadians suffering from conditions of unknown origin, many of which, as I mentioned, are those misdiagnoses given to Lyme patients. We have no idea how many in fact have Lyme disease, but we do know that number is significant.

Those chronically ill people are also the biggest user group of our health care dollars. Many of those people have had their careers stopped short. That affects employers from coast to coast to coast. Still others will be unable to enter the workforce and will instead draw on our public disability payment systems.

There is much more needed to be done. Victims and their experts must be allowed an equal voice at all levels from this point forward.

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

Thank you so much for the question.

When you talk about the cost, not only is it the cost of treating Lyme disease, whether it's a 10-day course or a nine-month course, but add up the costs of misdiagnosis, of putting people on treatments for diseases they don't have. You're not only setting back the health of the patient who is misdiagnosed, but that's also a very significant cost to our health care system, which is why the economic costs of Lyme disease form part of the surveillance program that Bill C-442 would put in place.

I've been very gratified—and I thank you for the question, Terence—by the fact that the Canadian Medical Association is absolutely in support of the bill. The letter will be shared so you'll all have it in detail. They support the implementation of a national strategy or federal framework because they believe that we need “to address the breadth of public health and medical issues surrounding the spread of Lyme disease in Canada”. They regard it as a new infectious disease threat. They're looking at in a very holistic way, looking at the various ways in which the bill will help patients.

The College of Family Physicians of Canada likewise wants to make sure that their representative on the Public Health Agency steering committee will help develop practice guidelines on Lyme disease. This is the medical community itself saying, “It's hard to diagnose. We need practice guidelines. We want to work with you. We want to make this happen.”

As I said, there's been a barrier around it, and I think there's a substantial attitudinal change happening. People used to say, “There isn't Lyme disease in Canada”, or “There isn't Lyme disease in my province”, or “We don't get Lyme disease on Vancouver Island.” These are all things that patients have told me they've heard. Now there's such clear evidence that it's spreading and we do have this illness in all parts of southern Canada that I've heard of.

So the medical community is supportive. I know the Medical Association of Canada would have provided a witness to the hearings on Bill C-442, but just due to timing they're not able to be here in person. But they do plan to submit a brief, and I'm grateful for the chance to mention that.

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

Thank you. It wasn't until you drew my attention to what you had seen in Europe, the expansion of tick populations and Lyme disease there, that I started looking into what is happening in Europe.

My bill does touch on this; Bill C-442 deals in paragraph 3(b) with guidelines that also touch on prevention. Of course, that is not quite the same thing as.... A portion of prevention could be the studies that you suggest, to understand exactly why it is spreading. The current prevalent theory is that because of changing temperatures caused by the changing climate, the tick population is spreading.

But we're also seeing other evidence. There was a story in the Times Colonist, the newspaper that covers part of my riding, from Victoria, that there was a raptor discovered—a dead hawk—that had a number of ticks around his eyes. When they analyzed those ticks, they found that some were not deer ticks, but they were also carrying the bacteria that carries Lyme disease. This is hypothetical, so please don't take it as evidence, but there certainly is anecdotal evidence that the bacteria is spreading from deer ticks to other kinds of ticks.

So it may be on the move in other ways that scientists have not yet quite understood. We know that it's more prevalent and we know that it is spreading, and not just where it started, around Lyme, Connecticut—that's why it is called Lyme disease—but into other jurisdictions, obviously including Canada, but also Europe.

Of course, that is the challenge for the medical community. When many of our doctors went to medical school, this wasn't something that was presenting itself as a serious cause of illness.

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

Thank you, Mr. Chair.

It is a great honour for me to appear before you as a witness on Bill C-442, An Act respecting a National Lyme Disease Strategy.

This bill was conceived in a non-partisan perspective in order to help people everywhere in the country. I hope that in an equally non-partisan spirit, we will be able to create the strategy set out in the bill.

The bill would introduce a collaboration framework involving the federal, provincial and territorial ministers, as well as representatives from the medical community and patients' groups, in order to expedite diagnosis and treatment of the disease.

I think all members are now quite familiar with the fact that Lyme disease is spreading, particularly across southern Canada.

As I just mentioned in French, I have to say that this is a very non-partisan effort. I am enormously grateful to all members and all parties represented in the House for support for this bill. At the top of my list is thanks to the Minister of Health, Rona Ambrose. I know her officials will be coming in the second part of the health committee's review of the bill.

Let me just explain what it is I hope my bill will do, and then I'll talk about some of the supporters we have for this effort. The support, both politically and from the expert medical community, is quite substantial. Of course, Lyme disease patients from coast to coast have been extraordinary in their support and in reaching out with petitions, which I think many of you have tabled in the House on behalf of your constituents, in support of the bill.

As any of you will know, as members, when you set out to write a private member's bill you're very aware of the constraints: it has to fall squarely within federal jurisdiction and it should not attach itself to any measures that involve spending money.

That said, I know that the Minister of Health would like to have some amendments made. I want to get that out right away. From my point of view, the amendments that the minister or the health department officials will bring to you, certainly the ones I've been consulted about, are absolutely fine.

I tried very hard; I called this the national Lyme disease strategy. It may work better in terms of avoiding any treading on provincial jurisdictions to call it a federal framework or something like that. I'm not prescriptive about what the minister brings forward, obviously. But we do want to make sure that it doesn't tread on provincial jurisdiction. That was my intention in drafting. To any extent that I failed to do that, I want to make sure that the bill is a purely federal effort that engages the other jurisdictions in a collaboration.

So that's the first thing to set out: the effort is to make sure that the federal Minister of Health takes the lead, but the engagement is truly across provincial boundaries in a way that's respectful of jurisdictional limits.

In that vein, I'll let you know that I was amazed to discover that just recently a bill has been tabled in the province in Nova Scotia that will mirror this one. So I think that might be the beginning of what we'll see across the country as more provincial jurisdictions are aware of the spread of Lyme within their own area.

I give credit to Health Canada that since 2009 Lyme disease has been a reportable illness. That's quite a lot of progress, because there was a time, a decade or so before that, when you would be hard pressed to find a jurisdiction that thought Lyme disease was a serious problem. There are horror stories.

The first person I knew with Lyme disease was a neighbour in Nova Scotia, Brenda Sterling. She's very prominent in the movement, so I don't mind mentioning her name. But when she first contracted Lyme, she kept trying to talk to provincial authorities in Nova Scotia. They told her they didn't have Lyme disease in Nova Scotia, so therefore she couldn't have it.

Imagine the change that's occurred. As I said, there's a bill before the Nova Scotia legislature that mirrors this bill.

So what will this bill do? Under this bill, the minister will be required to convene a conference. Now, my bill says within six months. The timing around that might change in terms of government amendments. I don't think that's material as long as it's clear that it must happen. The minister will convene a conference of his or her provincial and territorial colleagues in the departments of health, as well as representatives of the medical community, as well as representatives of patients' groups, and that group will work together to develop a strategy.

There are several key elements of what's missing for the best possible approach in Canada to this illness.

One is that we lag behind the U.S. in terms of awareness for prevention—i.e., when people go out on a hike. I was talking yesterday to the cameraman from CBC who interviewed me on this. He's a volunteer Scout leader. He said it's his second job, and he loves it. He takes the kids out in the woods. They have really ramped up their own awareness for tick awareness, such as checking each other for ticks.

We want people to enjoy the outdoors. We don't want people to get phobic about going on hikes and being outdoors. But we need the awareness to tell them to tuck their pant legs into their socks, to check afterwards, to have a friend check to see if they picked up a tick, and then to know what to do if they have. Awareness and prevention are key.

The next piece, which is much more complicated, is the diagnostic piece. In the letter of support from the Canadian Medical Association, which will be tabled with you in both official languages at your next hour's hearing—I've checked that with the clerk and that appears to be fine to do—the president of the Canadian Medical Association, Louis Hugo Francescutti, had this to say:

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.

We should find ways to share best practices across jurisdictional lines between members of the medical community so there is a shared understanding of best practices for diagnosis because, as the Canadian Medical Association has noted, with quick diagnosis, treatment is excellent. It's usually a course or round of antibiotics, and patients return to full health. On the other hand, as with my friend Brenda Sterling in Nova Scotia, left untreated, it's debilitating. When I met her she was already in a wheelchair, and I was shocked at the time to discover that she was in a wheelchair due to Lyme disease.

The next piece, of course, is better treatment and management, and that again can be done through sharing of best practices within members of the medical community and finding a recommended national approach that will reflect best practices for treatment of Lyme disease.

All of the materials that can be shared are described in the bill so that there's a public health aspect of this to increase the awareness to help the medical community with the treatment and management of this disease.

The bill goes on to describe the ways in which the Minister of Health will, in an ongoing fashion, share information and help the medical community and provincial and territorial colleagues to work together so that the spread of Lyme disease does not represent a significant threat of permanently debilitating illness to Canadians when it's easily treatable if properly diagnosed. Also there are ways to avoid contracting the illness by being aware of ticks and tick bites.

This is pretty straightforward. I just want to stress one thing about the illness. We know it is under-reported in Canada. How would we know this? In the United States last summer in 2013, the Centers for Disease Control and Prevention in Atlanta, Georgia, based on their understanding of the disease in the United States, increased their estimate of the prevalence of the disease tenfold from 30,000 understood cases to probably in the range of 300,000.

We can assume the same is likely the case for Canada. Since tabling my bill I've had literally hundreds of Canadians write to my office with personal stories. I've also had health professionals, both nurses and doctors, contact my office and say, “I know that in my own province of X, we have only x number of reported cases, but we think it's far higher.”

We are actually acting in a timely fashion. The Parliament of Canada is doing something really useful and helpful, and the Minister of Health in the lead can make a real difference in the lives of Canadians, those who are already suffering with Lyme, and those who can avoid suffering with the steps that can be taken through a federal framework.

I have one very last comment, Mr. Chair. This is not a case where parliamentarians should become doctors, or think we're doctors, or have the politics of the issue have any impact whatsoever on what the medical community decides around the issue. I think that's really important. In some cases in the U.S., there have been some areas where the medical community has felt that politicians went too far. I'm very grateful, again, that in Canada the established medical community and organizations are very supportive of this bill. We're not doctors. We're here to work on public policy.

With that, I open the floor to any questions anyone may have.

[The Chair, Conservative, Ben Lobb]

Good morning, ladies and gentlemen.

This is our first meeting on Bill C-442, and we have Ms. May here, who is ready to present. The first hour of the meeting will be allocated to her and her comments, and to questions and answers. In the second hour, we will have some additional guests.

Ms. May, you have 10 minutes or thereabouts. If you need longer, you have a bit more time.

[Bruce Hyer, Green, Thunder Bay—Superior North, ON]

Mr. Speaker, I have a petition regarding Bill C-442, the national Lyme disease strategy act, brought by the member for Saanich—Gulf Islands, which would develop a national strategy to ensure the recognition, timely diagnosis, and effective treatment of Lyme disease in Canada. We have a large and growing number of citizens in Thunder Bay—Superior North who have Lyme disease, and unfortunately, it is increasing with climate change.

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

Mr. Speaker, the second petition comes from residents of Brampton, Kingston, and Caledon. I am grateful for their support for the private member's bill that will be going to the health committee this week, Bill C-442, my private member's bill on a national Lyme disease strategy. I am very grateful to all members of the House for their support and for this petition.

[Patrick Brown, Conservative, Barrie, ON]

Mr. Speaker, I rise to present two petitions on Bill C-442, the national Lyme disease strategy.

National Lyme Disease Strategy Act

[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.

[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.

[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.

[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.

[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.

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.

Lyme Disease

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

Mr. Speaker, I rise today to present two petitions.

The first is relevant to business that we will take up later this afternoon in private members' business. My bill, Bill C-442, calling for a national Lyme disease strategy, is up for the second hour of its second reading. Citizens from Etobicoke, St. Marys, and other locations in Ontario have petitioned this House to support the bill. I hope that will be the case.

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

Mr. Speaker, the next petition is for my own private member's bill, Bill C-442, National Lyme Disease Strategy Act. I thank all members of the House, as I understand that at this point I have quite a lot of support. The petitioners from Milton, Brampton, and Thornhill also hope that the House will pass the bill.

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

The second petition, Mr. Speaker, is signed by over 2,500 Canadians from across Canada: within Ontario from Bolton, Ajax, and Toronto; in Alberta, Calgary, and St. Albert; in British Columbia, Victoria, and Penticton; and Prince Edward Island. I will not keep reading the places for all these petitioners, but they call for the House to pass Bill C-442, which went to second reading this morning, my bill for a national Lyme disease strategy.

National Lyme Disease Strategy Act

[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.

[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.

[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.

[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.

[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.

Lyme Disease

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

Mr. Speaker, the second petition is from residents of Caledon, Ontario; Barrie, Ontario; Salt Spring Island; and other locations. I am very honoured that so many petitioners are rallying for support of Bill C-442, the bill to bring about a national shared approach on the threat of Lyme disease. More Canadians are suffering from Lyme disease all the time, yet it is preventable and easily treatable if we could only share best practices and put in place the measures under the bill. It will come up for second reading on Monday.

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

Mr. Speaker, I rise today to present two petitions.

The first is from residents from my own community, from Victoria and surrounding communities in Sidney and some of the Gulf Islands. They ask, and I say this with the greatest of hope, that when Bill C-442, the bill for a national Lyme disease strategy, comes before this House on March 3, that these petitioners' petitions can be realized with passage to second reading and then ultimately into law.

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

Mr. Speaker, the second petition deals with my private member's bill, Bill C-442. I have been heartened by support from many members of Parliament in different parties in this place. The bill will come for second reading on Monday, March 3. These petitioners call for the passage of Bill C-442, to provide hope for many thousands of Canadians who are dealing with Lyme disease and who know that working together we can share best practices and improve the prevention, diagnosis, and treatment of this disease.

[Bruce Hyer, Green, Thunder Bay—Superior North, ON]

Mr. Speaker, I have a petition from Canadians all the way from Galiano Island to Thunder Bay, encouraging the House to pass the bill from hon. member for Saanich—Gulf Islands, Bill C-442, having to do with Lyme disease.

The petitioners feel that we need this bill because the science and medicine are running behind climate change. Lyme disease is an emerging problem, and we need to get on it.

[The Chair, Conservative, Dave MacKenzie]

Okay.

The third one is Bill C-442.

[Bruce Hyer, Green, Thunder Bay—Superior North, ON]

Mr. Speaker, I am pleased to present a petition on behalf of many Canadians, including those from Thunder Bay—Superior North, who support Bill C-442, an act respecting a national Lyme disease strategy, introduced by the member for Saanich—Gulf Islands.

Lyme disease is serious. A growing number of Canadians will soon be living in areas at risk of Lyme disease due to climate change and global warming. This bill would lead to a national strategy.

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

Mr. Speaker, it is my privilege to present this petition from Toronto—Danforth residents who are supporting the passage of the member for Saanich—Gulf Islands' bill, Bill C-442, the national Lyme disease strategy act, which would convene a national conference to deal with this under-treated and under-recognized disease in Canada.

I would also like to mention that one of the signatories is David Leggett, a long-time sufferer of this disease, who has led the education campaign among Canadians.

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

Mr. Speaker, the second petition is from residents of Galiano Island and Victoria in support of my private member's bill, Bill C-442. I am pleased that it has now been set down for second reading. It is the bill I will put forward as a private member's bill for a vote in early March. These residents call upon the House assembled to create in a non-partisan fashion a national Lyme disease strategy to deal with this dreadful illness.

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

Mr. Speaker, I rise to present two petitions. The first is from residents of Thorndale, Ontario, as well as within my riding, Brentwood Bay, Victoria and Saanich. They are calling on the House to give favourable consideration to Bill C-442, my bill calling for a national lyme disease strategy. I am hearing from literally thousands of Canadians who hope that this bill can be passed to provide them some relief and some hope.

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

Mr. Speaker, I rise today to present two petitions.

The first petition is from residents of my constituency, Saanich—Gulf Islands, from Sidney and Saanichton, supporting my private member's bill for a national Lyme disease strategy, Bill C-442, and they are very hopeful that it will receive non-partisan support across this House.

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

Mr. Speaker, my second petition is in support of private member's Bill C-442.

This is the private member's bill I submitted to have a national Lyme disease strategy. I think there is hardly a member of this House who does not know someone who has been affected by this terrible disease.

I am very encouraged by the level of support being received. The petitioners who signed the petition I submit today are from Salt Spring Island in British Columbia, in my riding.

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

Mr. Speaker, I rise today to present two petitions.

The first petition is from residents of Maple Ridge, B.C., as well as Oakville and Toronto, in Ontario. I am very grateful to the petitioners. They have collected petitioners' signatures to support my private member's bill, Bill C-442, calling for a national Lyme disease strategy. I hear from Canadians every single day who are suffering from this terrible disease. It is a non-partisan issue, and I hope the bill will be passed.

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

Mr. Speaker, it is my honour to rise to present two petitions. The first deals with Bill C-442. It is a private member's bill calling for a national Lyme disease strategy. I happen to be the person who tabled it, but I like to think it comes from all members of the House.

I have heard from many members of Parliament who have, as I do, constituents who are suffering from this terrible disease. This strategy will be of assistance to people who have Lyme disease, and significantly, will help with prevention and greater awareness.

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

Mr. Speaker, the second petition is signed by individuals in favour of my private member's bill, Bill C-442, a bill that would create a national Lyme disease strategy.

Lyme disease is a scourge. It is becoming an epidemic. This summer the U.S. Centre for Disease Control reported that the estimate for Lyme disease in that country has gone from 30,000 new cases a year to 300,000 new cases a year.

Like myself, these petitioners hope that the House will pass my legislation for a strategy.

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

Mr. Speaker, the last petition, and I am encouraged by its support from across the aisles, is primarily from petitioners in the Surrey area who are in support of my private member's Bill C-442, which calls for a national strategy to deal with the dreadful human tragedy that is Lyme disease.

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

Mr. Speaker, the second petition is on the subject of the private member's bill I put forward, Bill C-442, calling for a national Lyme disease strategy. These petitioners from Saskatoon, Saskatchewan and Brampton, Ontario, join with many thousands of others across Canada hoping the House can be united in seeking help for those who are suffering from Lyme disease and in providing greater prevention and information so that we will reduce the spread of this terrible disease.

[Gord Brown, Conservative, Leeds—Grenville, ON]

Mr. Speaker, I am rising today to present a petition signed by a number of my constituents in Leeds—Grenville. The petitioners call on the government to support Bill C-442, An Act respecting a National Lyme Disease Strategy.

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

Mr. Speaker, I am very pleased to rise today, and I wish to thank other hon. members who presented petitions today, as well, on the subject of Lyme disease and my private member's bill, Bill C-442. This bill would call for a national Lyme disease strategy to improve the sharing of best practices, federally and provincially, for diagnosis, cure and prevention of what is an extremely debilitating disease that is often misunderstood.

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

Mr. Speaker, I rise to present two petitions.

The first petition is from residents of Vancouver, Alberta, as well as within my riding, in Sidney, Salt Spring Island and Victoria, in support of private member's bill, Bill C-442. This is my bill calling for a national lyme disease strategy.

I am very gratified by hearing from so many members that they are also concerned in hearing from lyme disease patients in their own communities. I hope there will be full-party support for this private member's bill.

Lyme Disease Strategy

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

Mr. Speaker, I rise to present two petitions.

The first is from residents of Winnipeg supporting my private member's bill, BillC-442, calling for a national Lyme disease strategy. It is particularly timely, as this Saturday, May 11, is World Lyme Disease Day.

Lyme Disease

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

Mr. Speaker, the second petition is from residents of Sudbury, Ontario, and Langley, British Columbia, in support of my private member's bill, Bill C-442, to develop a national Lyme disease strategy.

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

Mr. Speaker, I am honoured to rise today to present two petitions.

The first is signed by residents literally from coast to coast, from Yarmouth, Nova Scotia, all the way to Vancouver, British Columbia. The petitioners call for the passage of my private member's bill, Bill C-442, which proposes to develop a national strategy on Lyme disease.

I am encouraged by the fact that so many members on all sides of the House appear to be supportive of this effort.

Lyme Disease Strategy

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

Mr. Speaker, I rise to present four petitions, two each on the same topic.

The first two are on the subject of my own private member's bill, Bill C-442, calling for a national Lyme disease strategy.

The first set of petitioners are from Bedford and Stellarton in Nova Scotia; from Delta, Penticton, Victoria and Surrey in British Columbia; and from Burlington and Oakville in Ontario.

The second set of petitioners are from Chilliwack, Surrey and Langley in British Columbia, as well as from Saskatoon.

Across Canada, Lyme disease sufferers are hoping that all members of this House will come to agreement on a national Lyme disease strategy.

Lyme Disease

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

Mr. Speaker, I rise today to present two petitions.

The first petition is from residents of Caledon, Erin and Brampton, Ontario, who are in support of my private member's Bill C-442, an act respecting a national Lyme disease strategy.

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

Mr. Speaker, I rise today to present two petitions. The first petition is from residents of Surrey and Langley in British Columbia, as well as from residents of Halifax, Nova Scotia, calling upon the House to look favourably on private member's Bill C-442, which I have tabled, that calls for a national Lyme disease strategy.

I am hopeful that members on all sides of the House will see fit to give the bill their support.

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

Mr. Speaker, I rise today to present two petitions.

The first is primarily from residents of Langley and Maple Ridge, British Columbia who are urging the House to support the private member's bill I put forward. Bill C-442 proposes a national Lyme disease strategy.

Canadians from coast to coast support this. Also, I hear from so many members of Parliament, on all sides of the House, who are hearing from their constituents of the debilitating, really dreadful symptoms, which are quite often misdiagnosed. Pulling together to ensure a national Lyme disease strategy would put us on the right path.

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

Mr. Speaker, I am very proud to rise today to present two petitions.

The first pertains to Lyme disease. I had the great honour of introducing Bill C-442 about this disease. The petitioners are asking all parties in the House of Commons to support this bill.

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

Mr. Speaker, I have the honour to present a petition signed by people from Montreal and Gabriola Island.

The petitioners urge all members to support my private member's bill, Bill C-442, which calls for the creation of a national Lyme disease strategy.

Patients and doctors across Canada tell me they support this legislation. I certainly hope my colleagues will join me with all-party support.

Lyme Disease Strategy

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

Mr. Speaker, I am also pleased to present petitions from residents across Canada—from Toronto, Vancouver and other locations—in support of my bill, Bill C-442, on a national Lyme disease strategy to deal with improving and sharing best practices in prevention, diagnosis and treatment.

Lyme Disease

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

Mr. Speaker, I rise today to present two petitions.

The first is from petitioners in Chilliwack, Vancouver and other locations in British Columbia, supporting my private member's bill, Bill C-442, which calls for the creation of a national Lyme disease strategy. I am hoping for support across all sides of this House.

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

Mr. Speaker, I am so pleased to rise today to present more than 500 names on petitions in favour of my private member's bill, Bill C-442, to put in place a national strategy on Lyme disease.

The petitions that I am presenting today come from Nova Scotia, British Columbia, Alberta and coast to coast, calling for this bill to be passed.

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

Mr. Speaker, I am pleased to rise today with two petitions. The first is from residents from Winnipeg, Saskatoon, and Bracebridge and Oakville, Ontario.

The petitioners urge members of Parliament to support my private member's Bill C-442, which would move Canada toward a national Lyme disease strategy. I am hearing from patients and doctors across Canada who support this legislation. I certainly hope my colleagues will join me with all-party support.

[Gord Brown, Conservative, Leeds—Grenville, ON]

Mr. Speaker, I present a petition today from some constituents in my riding of Leeds—Grenville. The petitioners call upon the government to support Bill C-442, the national Lyme disease strategy act.

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

Mr. Speaker, the second petition relates to support for a private member's bill that I put forward, Bill C-442, that calls for a national Lyme disease strategy. The petitioners are from Mississauga, Fergus and other areas of Ontario.

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

Mr. Speaker, I rise today to present two petitions.

The first petition is from residents of Alberta, Nova Scotia, British Columbia and Manitoba. The petitioners support the private member's bill I put forward, Bill C-442, calling for a national Lyme disease strategy. I hope to have support from members on all sides of the House.

[Ted Hsu, Liberal, Kingston and the Islands, ON]

Mr. Speaker, I have a petition from my constituents asking Parliament to support Bill C-442 from my colleague, the member for Saanich—Gulf Islands , the national Lyme disease strategy act.

National Lyme Disease Strategy Act

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

,

seconded by the member for Etobicoke North, moved for leave to introduce Bill C-442, An Act respecting a National Lyme Disease Strategy.

She said: Mr. Speaker, it is my great honour to rise today to present this private member's bill, for which I hope there will be support from all sides of the House. This is the ultimate in non-partisan issues. This is the ultimate in non-geographically limited issues. We are, in each of our ridings, facing an increasing threat to our constituents and their families from a very tiny threat, a little tick that is spreading and can bring debilitating illness to any one of us at any time.

I dedicate tabling this bill today to a very brave young woman who was with me earlier today at a press conference, Nicole Bottles. She was diagnosed in high school and is in a wheelchair waiting for her cure. I want to thank the Canadian Lyme Disease Foundation. I urge all members of the House to join me in working toward a national Lyme disease strategy.

(Motions deemed adopted, bill read the first time and printed)