Bill C-284

National Strategy for Eye Care Act

An Act to establish a national strategy for eye care

This enactment provides for the development of a national strategy to support the prevention and treatment of eye disease, as well as vision rehabilitation, to ensure better health outcomes for Canadians.
It also designates the month of February as “Age-Related Macular Degeneration Awareness Month”.

National Strategy for Eye Care Act

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

moved that Bill C-284, An Act to establish a national strategy for eye care, be read the second time and referred to a committee.

Madam Speaker, I am very excited to stand today for the second hour to speak on my bill, Bill C-284, which would establish a national eye care strategy, on second reading.

For many years, Canadians have been calling for a comprehensive national plan for vision health, including you, Madam Speaker. You have mentioned this issue many times. Historically, the federal government has lacked any substantive framework on the matter of public eye health care. As it stands, supplementary coverage has only been extended to particular groups of people who qualify for provincial medicare services.

The current structure has created huge gaps in access to care, leaving the majority of Canadians to pay for their eye health care expenses out-of-pocket or forcing them to work private insurance packages into their already narrow budgets. I find this system unacceptable.

The vision loss crisis in Canada requires a coordinated response, and this is what the national eye care strategy is all about. Here are some of the numbers, to give an even better idea of what is going on in vision health in our country. Over eight million Canadians, or one in five, have an eye disease. There are 1.2 million Canadians who live with vision loss or blindness. There were 1,292 deaths associated with vision loss in 2019 alone.

Meanwhile, 75% of vision loss cases can be prevented if patients are diagnosed early and have access to treatment. Dr. Arshinoff of Humber River—Black Creek has told me many stories of people who would have gone blind had they not been able to get immediate attention. Too often, we take our eyes for granted.

My grandmother died with a blinding eye disease, and I had a long-time friend and mentor who was also blind when he died. My aunt suffers from blindness related to macular degeneration today.

Age-related macular degeneration, glaucoma and cataracts are among the top five causes of vision loss here in Canada. AMD affects millions of Canadians and is the leading cause of blindness for those over 55. However, it fails to garner the same attention as other common eye diseases. Many of us in this room may also develop age-related macular degeneration, and as part of this bill, I would like to see February designated as macular degeneration awareness month to give us an opportunity to focus on the signs of AMD and what we can do about it.

There is a high percentage of seniors and school-aged children who have undiagnosed eye problems. Very few children had an eye test during the pandemic, and many also spent an inordinate amount of time in front of computer screens. Even more, over 3,000 Canadians are in need of and waiting for an eye transplant. The Canadian Transplant Society actively recruits Canadians to become organ donors, but many people have a fear about donating their eyes. In polls, over 81% Canadian respondents say they would donate their organs, but only 35% actually sign up to do that.

Losing one's vision increases mental, financial and social hardship. It can lead to a loss of mobility and inability to live independently, to drive, to read or to participate in physical activity. It can result in a loss of social interaction, which can often lead to depression and other mental illnesses.

Vision loss has a profound impact on individuals, their families and society, costing our economy an estimated $32.9 billion a year. Of this cost, $4.2 billion is attributed to reduced productivity in the workplace. Over half of that cost, $17.4 billion, is also attributed to reduced quality of life, which is primarily due to a loss of independence, especially in the aging population. Over $983 million was spent last year across Canada on injections to treat AMD.

A national strategy for eye care will allow all provinces and the government, as well as health care researchers and practitioners, to sit down at one table and jointly develop and implement the measures necessary to make sure that all Canadians from coast to coast to coast have equal access to eye care, no matter where they live.

Not long ago, I came across a heartbreaking story of a man who lives in Cambridge Bay, Nunavut. It has been five years since he last updated his prescription glasses, even though he has been eligible for a new pair for the last three years. He could not get an appointment with an eye doctor and he is still waiting. Some of the issues have to do with the pandemic, which caused gaps in people getting in for eye doctors' appointments, but a lot of it is because we take it all for granted. Nevertheless, the fact that access to eye health treatment varies widely from province to province seems so wrong to me. With Bill C-284, I am hoping to change that.

I am sure many colleagues have heard many similar stories while talking to people about their eyesight and when they last got their eyes checked. It is something that we just take for granted. By the time a person finds out they have a problem, it is usually too late.

Access to eye health care should not be treated as a luxury. It is a crucial service needed throughout all walks of life. Seniors need eye health care to keep themselves capable and protected. Working people need it to stay dedicated to their responsibilities and to not be excluded because of physical ability. Children and young adults need eye health care to study and navigate the world around them. Eye health care means having a safe and enjoyable quality of life.

Bill C-284, if passed, commits the government to a national strategy dedicated to improved access to eye care and rehabilitation services, a strategy that also envisions the creation of a vision desk at the Public Health Agency of Canada and investments in research to find new treatments to prevent and stop blindness.

The bill is also calling on enhanced access to eye health care for indigenous people who, for far too long, have been neglected and not had any access to any assistance on eye health care.

We take our vision for granted. From social isolation to depression to travel difficulties, there are so many challenges when one cannot see. Many people never stop to consider what it would be like to go blind. We have to increase the awareness of vision loss and what we should be doing every day to protect our eyesight.

I would like to see this piece of legislation move as quickly as possible, as I indicated. Thanks to all the support we have here in the House for this bill, as soon as it can get to committee, get through committee, back here and passed through the Senate, it would become law. I think there are many people across Canada, many of the organizations fighting blindness, CNIB and so on, that are desperately hoping that this time this is actually going to happen.

Throughout my 33 years in political office, my mentor, Paul Valenti, suffered from age-related macular degeneration and died two years ago. My grandmother, Annie Steeves, was blind most of her life, as is my Aunt Ruby Steeves. I am doing this bill for everyone but especially for them.

I am thrilled that in a position as an MP and on behalf of my family and all Canadians, I can truly make a difference by putting forward this bill, which will open the door for more recognition of vision loss and its implications and, of course, with the help of all members in this House and all parties that have indicated that they are very supportive.

Bill C-284 will have a direct, positive impact on Canadians' vision health now and for generations to come. For many years, optometrists, ophthalmologists, researchers and patient advocates have been calling for federal leadership on eye care. The CNIB, Canadian Council for the Blind and Fighting Blindness Canada are just a few of the organizations.

As I mentioned earlier, the member for Algoma—Manitoulin—Kapuskasing has been a leader in the fight for vision care in Canada and I am very happy to have you in the Speaker's chair today while I do the second reading.

We have started many great health care initiatives in the chamber over the past several years, including dental care and pharmacare. The national eye care strategy is the next important step in making health care accessible and affordable for all Canadians.

Making eye health, vision care and rehabilitation services a health priority requires our support. I call on all my colleagues in the House to continue to work together, to change attitudes toward blindness, to ensure that the 1.5 million Canadians with sight loss are understood and provided with the necessary supports.

I encourage all members here today to become champions for Bill C-284 and refer it to the health committee as soon as possible.

Together, we can continue the momentum to help the bill become a law for all Canadians.

[Gabriel Ste-Marie, Bloc, Joliette, QC]

Madam Speaker, I thank the hon. member and committee chair for her speech.

I am concerned about our youth's eye health. Research shows because of the ever-increasing use of screens, phones and tablets, and also because youth are spending more and more time indoors, there will be an epidemic of retinal detachments in the future. This is a serious eye condition.

Could my colleague comment on this concern?

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Madam Speaker, what I have found is that when I started to do the research on Bill C-284, I knew very little about it. I have been fortunate to have pretty good eyesight all of these years, other than what my own family experienced through blindness.

What I have learned is that the number of things that happen with one's eyes is quite remarkable. When one suddenly starts to notice something about one's eyesight not being the way it was the day before, one needs to get immediately to a doctor, an ophthalmologist or an emergency ward to have that looked at.

Very often, people go completely blind within hours when different things happen, such as the pressure behind their eye and all of those things that the ophthalmologist and optometrists and so on will tell us about.

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, in terms of eye care, the member is absolutely correct to say that it is critical. However, the cost of eye care is increasing and, oftentimes, what we are seeing is that it is getting delisted in terms of coverage under the health care plan.

That certainly is the case here in Ontario.

From that perspective, what does the member have to offer in ensuring that coverage is provided so that people can in fact access the necessary health care and eye care that they need?

[Judy Sgro, Liberal, Humber River—Black Creek, ON]

Madam Speaker, I enjoy, very much, working with my hon. colleague and I know how hard she fights for her community and, in fact, for all Canadians in a variety of different capacities.

I think that one of the things that would come out of Bill C-284 is the fact that the provinces and the federal government have to sit down at the table together and look at the huge cost to society as a result of not having sufficient health care when it comes to eye vision and vision loss. The fact is that they would have to sit at the table together, look at the numbers, look at the impact that it is having on society, and come up with solutions.

I think that is the only way that we are going to get this to move forward, because we have that interaction between the provinces and the Government of Canada. There needs to be more co-operation and that is what a vision desk would do. It would provide that opportunity to do the analysis required and recognize the need for the investments.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Madam Speaker, I would like to thank the member for putting forward this really important bill. Eye care is absolutely critical for Canadians. I say this as just a few months ago my husband was a patient having cataracts removed from both eyes, and seeing how much technology has changed, seeing how many things are available now to patients and how we can make that better for all in putting this forward.

On World Sight Day in October, I had the opportunity to meet with an incredible group that came with OneSight. In that group was Dr. Stan Woo from the University of Waterloo. He and I just connected; I guess it was the energy and excitement for what he does at the University of Waterloo, including the research and development and seeing what they can do for patients to ensure that they have the proper care. When there are opportunities for reversals they know what to do to ensure that the treatment, such as medication, can be used. The knowledge and what they are doing there, not just at the university but shared across this great country, and how they can ensure that access to eye care is available from Nunavut down to the Maritimes, is extraordinarily important.

People at the university, when I was there on my visit on January 20, shared with me all of the incredible things that they were doing for research. It was noted here in this bill: “promote research and improve data collection on eye disease prevention and treatment”. Being at the university, that is the type of stuff that I saw being done there: making sure that they knew what was happening among their own patient base and making sure that they had the expertise across the country working to ensure the best technologies were going to be there so that the future of eye care was going to be enhanced.

One of the best parts of doing research on private members' bills is looking at what I saw on cataract surgery, where it suggested that there are two separate surgeries. I brought my husband home just a couple of weeks before Christmas, after having double cataract surgery where he had two cataracts on one eye and one on the other, and wearing these cups on his eyes. Within 24 hours I woke up to a husband who for the first time could actually see me. I do not know if he wanted that, but he actually saw me for the first time because he was as blind as a bat in the morning. From the research I was doing, I saw that they used to do them separately and now they can do them together. It is all of this treatment and research and how they can do patient care better.

This is the type of work that I would hope we would see in a national eye care strategy, and promoting the information and knowledge-sharing between the federal and provincial governments and in relation to eye disease prevention and treatment.

I was very grateful that the member focused on four key issues here in looking at macular degeneration, cataracts, glaucoma and diabetic retinopathy. These are four key things that we see especially in our aging population.

For instance, AMD is age-related macular degeneration. We know that there are approximately 2.5 million Canadians being impacted by this and it is impacting people my age and older. It impacts younger people as well, but this is usually something that we see in the aging population, 55 and older.

Understanding things like reducing smoking, diet and genetics in the family through awareness campaigns and what we can do as the national strategy is really important so that people understand their vision. Some of the diseases have no symptoms, so it is important to make sure that we have a program so Canadians in every part of this country, whether they are living in indigenous communities or well-developed communities, have access to this type of care as well. So many of these diseases have no symptoms but absolutely need the kind of care that they have.

We can also look at things such as cataracts, which is the most common type of vision loss. It is something very simple. Many Canadians are going around wearing their glasses. I lose my glasses all the time. People could have that type of surgery, knowing that each and every day it is getting better. I can remember my father having his cataracts removed and now my husband. I am just seeing that with the research we are doing by the doctors working together, we are actually providing great programs and great opportunities for patient care.

Glaucoma is impacting over 728,000 Canadians, which is related to age. I will read this about it:

Glaucoma affects more than 728,000 Canadians and takes the form of a number of related disease types. The most common types are open-angle, which is more prevalent and can go unnoticed due to a lack of early symptoms, and angle-closure, which can be painful with a sudden onset.

These are the things that we learn in research, and being members of Parliament, we get to do the research and learn about these things. It is important that all Canadians understand this.

Currently, there is no cure for glaucoma, but there are treatment options. When people have pressure in their eyes and may not understand what it is, they need to recognize the importance of going to see an optometrist or ophthalmologist to ensure they get the proper care they need.

I am also very supportive of clinical trials. As I said, there is work being done at the University of Waterloo and work being done at the London Health Sciences Centre in my hometown area, in my backyard. We have seen some incredible research, not only at the University of Western Ontario, but also throughout the Collip Circle area, where people are working to make sure that patient care is the number one priority.

Finally, when we are looking at this, I want to talk about the considerations. The bill notes, in subclause 2(3), “The national strategy must take into consideration existing frameworks, strategies and best practices related to the prevention and treatment of eye disease, including those that focus on addressing health inequalities.”

I will let the member know that I am very supportive of this bill, but this is where I have to say the government approach has to be right. We cannot do what it has done in the past.

We know the Canadian Dental Association, back in 2014, had a national oral health strategy. We saw the hygienists do it. We saw a number of organizations talking about oral and dental care. When it came to having a program with the government and Canadian dental benefits, it took none of those suggestions.

Instead, the government implemented its own dental program, which was not supported by the Canadian Dental Association at the time because it was not part of those discussions. That is one of my only fears. We need to make sure that people are at the table. We need to make sure that we have the researchers, the ophthalmologists, the optometrists, the patients and the academia, and that we have everybody working together so we have a proper strategy. Unlike the dental program, which was brought out by the government, not everybody was at the table. When we are talking about that, we need to make sure we have diverse opinions as well.

The reason I will continue to elaborate on the Canadian Dental Association is that the government has talked about the number of children who have been impacted by this program, which is sending out cheques to parents. As a person who comes from the dental health field, I would have loved for the government to consult with members of Parliament.

I actually used to go out to teach about dental health. If someone wanted to see a lady who could teach them how to brush their teeth, or if they wanted to sit in my chair, I would show people how to do their little, round brushing.

Those are the types of things that we should be focused on when we are looking at a dental health program. Instead, we saw a government say that it was going to send cheques out to Canadians, and that they will go to get their dental health needs dealt with.

Right now, we are in a crisis in Canada. Families cannot afford to put food on their tables. The government is coming out talking about the number of families, and I think they are saying 250,000 Canadian children have been able to use this program. However, I ask how it got those numbers. Nothing has been audited. We do not have information coming from the Canadian Dental Association or any of the providers that would be providing this type of information because they would not know. All we know is that we gave out cheques to families.

We have the healthy smiles program, which has been working here in Ontario. We should have been using its existing framework and working on that. That is the same type of work I want to see here. I hope we have success with this program and strategy because Canadians need it.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, I thank my colleague, the hon. member for Humber River—Black Creek, for introducing this bill.

Let me begin by saying that vision health is important. Obviously, it is a component of overall health, but one that is often underestimated. My Conservative colleague has given some personal examples to show that quality of care can change lives and change people's quality of life. I thank the member who introduced this bill.

There are several important elements in the bill, one of which involves raising awareness. It seeks to designate February as age-related macular degeneration awareness month. Obviously, this is important. In my opinion, we should never miss an opportunity to remind people of the importance of issues that affect us all. We all have daily obligations that keep us very busy, and these issues must always be brought to the forefront.

The bill provides for the development of a national strategy. Many national strategies have been proposed lately, including for autism, cancer and diabetes. I am skeptical about the effectiveness of these national strategies, because they generally lead to the tabling of a report that is ignored by the government most of the time. I hope that will not happen in this case if this bill is adopted. However, it needs to be said that national strategies often face the same fate as Labatt 50, in that they get shelved.

Although we agree in principle, let us be careful not to encroach on Quebec's jurisdiction. This bill seeks to raise public awareness, but it affects health, which is a provincial jurisdiction.

That being said, the issue is truly important. I think we know the data. Data from 2019 shows that 1.2 million Canadians suffer from diseases that could lead to vision loss, and 4.1% of those people could become blind. We know that eight million Canadians suffer from an eye disease that may lead to blindness. For some of these diseases, blindness is preventable.

We know that the direct annual health care costs related to these diseases leading to vision loss can reach up to $9.5 billion. Of course, there are human costs, but there are also social costs, such as lost productivity because of these diseases, and those costs can reach $4.3 billion per year.

I mentioned age-related macular degeneration earlier. With the growth and aging of the population, the costs related to those diseases could increase substantially. These are issues of critical importance.

Let us not forget that health is a provincial and Quebec jurisdiction. Quebec already has a number of programs in place to address various ocular conditions. Vision care services are covered by the government in Quebec for people under 18 years of age and people aged 65 and over. Last month, reimbursements for ocular prostheses were increased. It had been 30 years since those amounts had been increased, so that is progress.

This also serves to show that Quebec and the provinces need funding, transfers and money to be able to cover these programs. Developing a national strategy is all well and good, but the levels of government that are responsible for providing this care on the ground must be properly funded.

The RAMQ's visual devices program helps people obtain assistive devices like video magnifiers, ocular prostheses, night-vision goggles and Braille typewriters. These programs seek to improve the quality of life of persons with visual impairments, but they are expensive.

I will say it again. As the population ages, these diseases will become increasingly common. We will need to be in a position to improve the quality of life and productivity of the people who live with them.

There is talk of having a national macular degeneration awareness day, but I have to say that I would have liked this bill to include a national degeneration of health transfers awareness day. I offer that as a suggestion. For two years or more, the provinces and Quebec have been calling for $28 billion a year in extra transfers for health; that way, the federal government's contribution to provincial spending on health would reach 35%.

I know that this cause is important to my colleague and that she is well-meaning, but inside these envelopes there could be money for eye care. A national strategy and a report identify a number of things, but do not provide care to those who need it, care that could change their daily lives. The government is obviously short-sighted about the needs of Quebec and that is rather sad.

As I said, the aging population is going to increase the cost of health care and these transfers are necessary. In response to the aging population, more should be done in research and development and to expand our programs, including support programs for those who have vision problems.

There is also a shortage of workers, which means that we will be trying to keep older people in the labour market. We know that vision problems are bad for productivity and for the economy. They are also bad for those who want to keep working.

Statistics Canada's most recent report states, and I quote, “the percentage of people with self-reported good vision without correction decreased with age.” That is a bit like the Liberal government's vision regarding health transfers. It has been diminishing with age. The government's vision has been diminishing for eight years now.

For almost two years, we have been calling for a summit to be held with the provincial premiers and the current Prime Minister to discuss these issues. Instead, what the government did was to impose conditions on the provinces, which means that they are currently unable to enhance their existing programs or design new programs that would provide people with better eye care.

It seems as though the Liberals might need some Bloc Québécois glasses to better understand the needs of Quebec. I would like to offer them mine. Practically speaking, that would help them to provide care to those who need it, which could make all the difference in people's self-esteem, how they function in society, and their work and family life. This is a human issue. We are all equal when faced with the various health problems we may experience throughout our lives, and we should all have access to care.

Although I am clearly making some jokes, I hope my colleague realizes that I welcome her initiative. I know that she has been holding consultations and reaching out to various groups. Her intentions are excellent and, as I said, we agree in principle. We will be proposing amendments, but I understand that this is an important issue for my colleague, and I acknowledge that.

I will close by saying that the statistics clearly demonstrate that the issue of degenerative vision affects women in particular. I do not fully understand what causes this, and I will not presume to be a doctor or biologist, but I do know that there are also gender equality issues. Helping people become more aware of an issue, more aware that care is needed and that this affects women more than men—there is a fundamental equity aspect to that.

As I mentioned, we will support it in principle, study it in committee and act in good faith. We are skeptical about the outcome of these major strategies, but our colleague is certainly making it possible to discuss this important issue, raise public awareness and reflect on the issue of vision care. I thank her for that.

[Jenny Kwan, NDP, Vancouver East, BC]

Madam Speaker, before I begin my speech on the bill today, I want to take a moment to recognize today as the National Day of Mourning, to honour every worker who goes to work, and to say very clearly that they deserve to return home safely at the end of their workday. I would also like to take a moment to remember those who have been injured or lost their lives, and to commit ourselves to fighting for a safe work environment for all workers.

I am very pleased to rise today to speak in support of Bill C-284, an act to establish a national strategy for eye care. I would like to thank the member for Humber River—Black Creek for introducing this important bill with respect to eye health for all Canadians. New Democrats support this bill and the important steps it would take to improve access to eye care for all Canadians.

This legislation would set out a national strategy to support the prevention and treatment of eye disease to ensure better health outcomes for Canadians. It states the following:

(2) The national strategy must describe the various forms of eye disease and include measures to

(a) identify the training, education and guidance needs of health care practitioners and other professionals related to the prevention and treatment of eye disease, including clinical practice guidelines;

(b) promote research and improve data collection on eye disease prevention and treatment;

(c) promote information and knowledge sharing between the federal and provincial governments in relation to eye disease prevention and treatment; and

(d) ensure that Health Canada is able to rapidly consider new applications for treatments and devices used for macular degeneration, cataracts, glaucoma and diabetic retinopathy.

This legislation also designates the month of February as age-related macular degeneration month.

Organizations including Fighting Blindness Canada, the Canadian Council of the Blind, the CNIB, Diabetes Canada, the Canadian Association of Optometrists, the Canadian Ophthalmological Society, and the Canadian Association of Retired Persons have advocated for a national eye care strategy for many years, and it is long past time for action on this issue.

Sadly, eye health has been underfunded and deprioritized in Canada for far too long. As a result, millions of Canadians are being put at unnecessary risk of vision loss because they lack access to eye care. Currently, access to eye care varies widely from province to province, resulting in variable health outcomes and exacerbating inequalities in our health care system. As well, 39% of Canadians do not have access to vision health benefits. This is wrong. Over eight million Canadians are living with an eye condition that puts them at significant risk of blindness. An estimated 1.2 million Canadians are currently living with vision loss, with many facing a lack of investment in services and supports that impacts their ability to live life to its fullest. This number is expected to grow to two million by 2050. That is staggering.

Routine eye exams play a crucial role in the prevention of vision loss. If certain eye diseases are diagnosed early enough, they can be effectively managed before expensive and sometimes invasive measures are required. If diagnosed early, and if people have access to treatment, vision loss can be prevented in 75% of cases. Further, 70% of existing vision impairment in Canada is estimated to be correctable with prescription glasses. A sizable proportion of correctable vision impairment is related to the barriers to accessing vision care in Canada.

Most guidelines recommend having an eye exam once a year for people aged six to 18, or 65 years and older, as well as for those with diabetes or an eye disease. For healthy people aged 19 to 64, one visit every two years is considered sufficient. For many Canadians, this is out of reach due to out-of-pocket expenses, and 39% of Canadians do not have access to vision health benefits. Vision care is not a luxury; it is health care provision and must be treated as such.

However, some provinces are moving in the wrong direction and reducing access to eye care for those who need it the most. For instance, the Conservative government in Ontario announced that, starting September 1, free annual eye exams paid for through the Ontario health insurance plan will no longer be available to all seniors.

A study commissioned by the Canadian Council of the Blind and Fighting Blindness Canada has raised alarms on the state of vision care in Canada and the impact of the COVID pandemic on eye care services. In 2020, 1,437 Canadians experienced vision loss as a direct result of treatment disruptions, and the percentage of Canadians reporting that they had an eye exam within the last two years declined between 2019 and 2021.

The federal government must lead the way in saying that eye care is health care and improving access to services and treatment.

New Democrats have always stood for publicly funded health care, from head to toe, including eye care. Our founding leader, Tommy Douglas, fought tirelessly and relentlessly for the universal public health care system that has become a fundamental Canadian value. In fact, the notion that every person deserves access to health care as a basic human right, regardless of their ability to pay, was one of the founding principles of the New Democratic Party in 1961. It was always the NDP’s intention that the public health care system would include eye care. At the founding convention, the NDP stated, “Believing that a country's most precious possession is the health of its citizens, the New Party will introduce a National Health Plan, providing benefits to those who need them without regard to their ability to pay. The plan will cover a full range of services: medical, surgical, dental and optical treatment, as well as prescribed drugs and appliances.”

This belief remains an unfinished project, as many services, such as eye care, continue to be left out of Canada’s national health system. However, the NDP’s position and advocacy have not wavered. The NDP’s 2019 platform committed to achieving head-to-toe public health care, including eye care, for all Canadians. The NDP’s 2021 platform also committed to a long-term path to providing public coverage for eye care, along with other health services.

In May 2021, the member for Algoma—Manitoulin—Kapuskasing introduced Motion No. 86. I want to thank the member for her leadership and vision, no pun intended, in bringing it forward. This motion called on the federal government to work towards the creation of a national strategy for action on eye health and vision care, and that has brought us to where we are today with the bill before us, so I thank the member for that.

I am pleased that my colleague from the Liberal Party agrees that we need a national strategy for eye care, and I hope that members from other parties will also support the bill.

In 2003, the Government of Canada made a commitment at the World Health Organization to develop a vision health plan for Canada by 2007 and implement this plan by 2009. Well, it has been 20 years since the Liberal government of the day made this commitment, but to date, no plan has been developed.

As recently as July 2021, the Government of Canada voted in the UN General Assembly to enshrine eye health as part of the United Nations' sustainable development goals. In this resolution, the establishment of a national vision health plan was endorsed again by Canada. It is time for action and leadership on this issue at the federal level.

I hope that all members of the House will listen to the experts and support a national strategy for eye care by voting in favour of Bill C-284. Eye care is health care. It needs our support. It needs all levels of government coming together, and we need to recognize that.

[Mel Arnold, Conservative, North Okanagan—Shuswap, BC]

Madam Speaker, it is an honour to rise today and speak to Bill C-284, put forward by the member for Humber River—Black Creek. The bill addresses a national strategy for eye care. It is an honour to speak to this today because my wife worked at an optometrist's office for 23 years.

I had not expected to speak to this bill, but I am honoured to be able to do so today and to relay some of the experience that she had and that I had in working with the great doctors there. Dr. Beckner, Dr. Allaway, Dr. Ewanyshyn, Dr. Thompson and Dr. Geire have all provided such professional health care in our community of Salmon Arm, as all optometrists do across this country.

What I learned from speaking with them and with my wife about the importance of eye care is something that I think all of us in this chamber should see. We should see that eye care and the health care issues that can be discovered through regular eye care are very important.

There is a long list of diseases and health care problems that can be discovered through a regular eye exam. I suffer from dry eye. That, in itself, is just more of a discomfort, but dry eye causes a person's eyes to water. Tears are not actually the fluid that someone's eyes need. They need the oils that come out with those tears. If they do not have enough of the oils, the eyes feel dry and the person continuously tears more. When I am exposed to sunlight or to wind, I suffer that much more, but this is something that optometrists can help with.

We have heard others speak about cataracts today. The advancements that we have seen over the last number of years in making an operation to address and remove cataracts have continuously improved the lives of seniors.

I have not gone through that process yet, but because I go to see an optometrist regularly, I have been told that I am in the very early stages. I am a long way from needing that operation yet, but I am confident that by regularly attending an eye exam with an optometrist, I will hopefully know when the time is coming that my vision has been impaired.

Another instance that I was not aware of is something that is done by optometrists called a visual field test. That is where the optometrist or their assistant can check for the range of vision out of one's eyes. People might think that everyone would have very similar range of vision, but they do not.

I had a case where my eyelids were actually longer and more relaxed, so that they were coming down and blocking my vision. It was a fairly simple operation. I just went into an eye surgeon's office and had it done one afternoon. There was no problem with my vision. I had a short recovery.

However, in other people, without having that addressed, they can lose their field of vision. It could be something as significant as not seeing a stoplight. Because it is up at the top level of where they are looking, they may not see a stoplight turn red in front of them. Something as simple as that can be picked up by an optometrist with a visual field test.

We have heard of so many other eye health and actual body health issues that can be picked up through a regular eye exam. These include diabetic retinopathy and glaucoma. We have heard today that 728,000 Canadians are suffering from glaucoma. There is also retinal detachment. A lot of people do not know what this is, but if the retina becomes fully detached from the back of the eye, it causes permanent loss of vision. Optometrists and their assistants, through eye exams, can determine if this is happening; early intervention is a key piece to making sure that this sight loss is not permanent.

Diabetes is another issue. I had that explained to me when I went in for an eye exam. They look through very powerful cameras and lights at the blood vessels in the back of the eye. Often those blood vessels cross each other and, if there is extra pressure where they cross, they can identify a bulge in the blood vessels. That can be used to identify whether there is a possible issue with diabetes, high blood pressure and other things that are part of this. I am neither an optometrist nor a doctor, by any means, but these are pieces that I have picked up by listening and going in for regular eye exams.

I hope this bill will lead to not really what is said in the bill, but something that I hope can be addressed at committee stage when looking at this bill. A lot of the terminology in the bill itself refers to “eye disease”. I would be interested in following this as it proceeds through the committee stage to see whether the bill continues to speak to eye disease, or whether it would possibly change to “eye health” and “overall health”, because so many things can be picked up through the eye exams, which I have just spoken about.

The bill does not really address the issue of the availability of training for optometrists in the country. One thing I have noted, after looking quickly, is that there are two schools of optometry, one in Waterloo and one in Montreal. There are none in western Canada. There reflects an inequity in training for those who want to become optometrists.

It is a seven- to eight-year program, and it is very much like becoming a family physician. It is very expensive training, and there is extra cost for students coming from western Canada to those training centres, which are only available in eastern Canada. I am hoping that during the committee stage, that may also be looked at, or at least something is included in the strategy to include the availability of training in other parts of the country. It is obviously an added expense for those from the west, but anyone from the north would be much more burdened by the extra cost.

The purpose of this bill is admirable. The member spoke about her family members who lost their sight. That has not happened in my family, as we have been fortunate. We have been fortunate enough to be able to discover if there were eye problems ahead of time. We were able to get glasses, corrective lenses, contacts lens, whatever was needed, to continue our daily lives. If we can put together a strategy so that many more Canadians can retain their sight, no matter where they live, what their background is, what their wealth or lack of wealth is, that is an admirable goal. As I said, I will be happy to follow this bill as it goes through the committee stage to see if we can improve upon it and make sure that it deals, not just with eye disease, but with eye health and overall body health.

I have heard other members recognize that today is the National Day of Mourning for those who have lost their lives in the workplace from workplace disease or illness. One of my staff members attended a ceremony in my riding today. Workplace diseases can also affect eye health and overall human health.

I am grateful for the opportunity to stand to speak today, and I look forward to following this bill through the process.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I am pleased to be joining this debate. Like the member said previously, today is the National Day of Mourning for those who were injured or killed in the workplace. That reminds me, before I get into the subject matter of the bill, that there used to be a Sobeys in my riding in Douglasdale on the Douglasglen side. I do not know if many constituents know this, but there is a plaque there. There used to be a factory there where five or six workers were killed many decades before. That happens to be on the side of a Gold's Gym. I think most people have forgotten it, because it kind of sits in a corner, but it has a very lively description of that event and what happened, so this is an important day for all of us to remember.

We are on this private member's bill we are debating today. I obviously have eye care needs. I wear glasses now. About 10 years ago I realized I had trouble driving at night, because I could not see white lines very clearly. I went to see my family's optometrist, and they said I do need glasses. It is not very bad for me, but it runs in my family on two sides, and that is why I will be supporting the bill.

On my father's side, he has had many problems with his eyesight throughout most of his life. He still has very thick glasses made of glass; they are not the plastic ones, because glass is the only type that can actually help him with the type of eye care he needs. There is my brother. Shortly after we landed here in Canada we thankfully obtained Canadian citizenship, because I do not know if we could have afforded the expensive operations my brother required to keep his eyesight. He would have lost his eyesight if not for the Quebec health care system at the time. He almost did, because the care being provided at the time was not as good as it should have been. His eyes were actually infected, so he lost quite a bit of his eyesight. He is legally blind in one of his eyes, and the doctors told him just a few years ago, just before the pandemic, that if he did not start practising and doing different exercises to strengthen his muscles, he would have his driver's licence taken away eventually. It is very difficult to keep one's job if one loses their eyesight in Canada. He would still be able to see enough, but he just would not be allowed to drive anymore.

I think this is an important strategy for this Parliament to debate. Like the previous member who spoke, I think there is a lot more that could be included in the private member's bill. Hopefully the member would be willing to consider some of those amendments.

I know it is being moved by the member for Humber River—Black Creek, and I salute her efforts on this. She is a long-time parliamentarian. I have a lot of respect for her work and her time in this House.

I do have a Yiddish proverb, so I will put it in now, just in case I forget about it later on: “When the heart is full, the eyes overflow”. It is a beautiful proverb. It describes when someone is so happy they begin to cry out of happiness, and it usually blocks their eyesight. If there is a great joke or the situation one finds themselves in, typically with family, fills them with so much mirth it brings tears to their eyes, it is a good kind of happiness.

I will recognize the fact that the member is also going to be making age-related macular degeneration month in the month of February. It happens to be the same month my brother was born in, so I just thought that was providence. It is nice to see as well. It does not just happen to the old. Like I mentioned, my brother almost lost his eyesight when he was little, and he needed an operation.

All my children are affected, as many members know, by a rare chronic kidney condition called Alport syndrome, and although it is a kidney condition, it also affects the eyes. It affects the eyes and can lead to four conditions. One is peripheral coalescing fleck retinopathy. Do not ask me what that is in detail. I hopefully never will discover. The others are corneal opacities, anterior lenticonus and cataracts, and temporal retinal thinning.

My youngest son, Enoch, has glasses already. His need for glasses is related to this rare kidney condition that also affects the eyes and all the organs of the body. In his particular case he will probably need both hearing aids and glasses. Maybe some day we will get to the point where we will do a hearing aid national strategy in this place, but eye care for my children is something we are always watching for, because it is something they need.

I know many of us are looking at seniors who suffer through age-related loss of sight, and that is something I see in my parents as well. It also happens for the young.

Both sides of my family have members, old and young, who are affected by the need for better eye care. Other members have mentioned that eye care in Canada does not come cheap, depending on whether someone needs basic eyeglasses or if they need more attentive care from an ophthalmologist.

In the case of my family, we do need of an ophthalmologist, because my family members require much more in-depth care. The Province of Alberta provides excellent coverage for young people, those under 18, but especially those under 12 get excellent coverage for their eye care.

In the case of my children, like I said, because of this rare chronic kidney condition, they get a lot of specialist follow-up for their eyes. I met a lot of youth who needed much more care as they got older because of this condition called Alport syndrome, which leads to a degeneration in the eyes much earlier in their lives.

As we debate the importance of both research and the quality and availability of care, some members mentioned the possibility for improvements and additions to this private member's bill, maybe expanding in some areas and perhaps tightening in certain areas.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Unfortunately, the member's time is up for now.

The time provided for the consideration of Private Members' Business has now expired and the order is dropped to the bottom of the order of precedence on the Order Paper.

It being 2:30 p.m., this House stands adjourned until next Monday at 11 a.m., pursuant to Standing Order 24(1).

Have a good weekend, everyone.

(The House adjourned at 2:30 p.m.)

The House resumed from April 28 consideration of the motion that Bill C‑284, An Act to establish a national strategy for eye care, be read the second time and referred to a committee.

[Sylvie Bérubé, Bloc, Abitibi—Baie-James—Nunavik—Eeyou, QC]

Madam Speaker, I am pleased to rise to speak to Bill C‑284. As members know, this enactment provides for the development of a national strategy to support the prevention and treatment of eye disease to ensure better health outcomes for Canadians. It also designates the month of February as age-related macular degeneration month.

The preamble of Bill C‑284 reads as follows, and I quote:

Whereas vision loss in Canada is associated with a number of causes, including macular degeneration, cataracts, glaucoma and diabetic retinopathy;

Whereas millions of [Quebeckers and] Canadians live with eye disease that could lead to vision loss or blindness if not treated;

Whereas it is estimated that vision loss costs [Quebeckers and] Canadians billions of dollars every year, both in financial costs and in loss of well-being;

Whereas the loss of central vision can severely impact a person's independence and quality of life;

Whereas coordination and information sharing between the federal and provincial governments is needed to ensure new treatments are made available, to prevent and treat eye disease and to prevent health inequities among people with vision loss;

It also states, and I quote:

And whereas Parliament considers that it is desirable to be proactive in the fight against vision loss and to implement a national strategy on eye care

In the same vein as many bills introduced over the past few Parliaments calling for autism, cancer or diabetes strategies, this bill calls for a strategy in the form of a report on eye health. Not surprisingly, the bill has the support of the Canadian Ophthalmological Society and the Canadian Association of Optometrists. In the wake of the introduction of the bill and World Sight Day on October 13, these groups published a survey that highlights the lack of understanding among Canadians about this important aspect of our health.

As we know, the strategy proposed in Bill C‑284 is built on four pillars:

identify the training, education and guidance needs of health care practitioners and other professionals related to the prevention and treatment of eye disease, including clinical practice guidelines;

promote research and improve data collection on eye disease prevention and treatment;

promote information and knowledge sharing between the federal and provincial governments in relation to eye disease prevention and treatment; and

ensure that Health Canada is able to rapidly consider new applications for treatments and devices used for macular degeneration, cataracts, glaucoma and diabetic retinopathy.

The Bloc Québécois will vote in favour of the principle of the bill, because eye health is important for people's quality of life.

All in all, the bill itself does nothing. It only forces the government to produce a report that will establish a national strategy for eye care. Furthermore, designating the month of February as age-related macular degeneration month is a symbolic measure.

Although health services, including eye care services, are the jurisdiction of Quebec and the provinces, this bill gives the federal government a role by funding research and approving medications or devices.

The bill overall respects Quebec's and the provinces' jurisdictions. That is why the Bloc Québécois supports it. However, the Bloc will take the time to study the bill to ensure that the federal strategy is complete and complements the actions of the Quebec government.

In Quebec, optometry services are available to people under 18 or over 65, and emergency services are covered for everyone. There is also a visual aid program, which allows any individual with a permanent visual impairment who is covered under Quebec's health insurance plan to obtain visual aids such as magnifiers, an optical system, a calculator, a Braille typewriter, a white cane, an electronic obstacle detector, night vision goggles, and the list goes on.

The program also offers financial help to get a guide dog, as well as resources for students. Speaking of guide dogs, I am going to talk about a fantastic Quebec organization that does remarkable and indispensable work. I am talking about Mira.

In his childhood, founder Éric St-Pierre developed a passion for raising dogs. He trained dogs on the family farm, following his father's advice. His ease and natural talent with the animals led him to undergo professional training in order to have a career training guard dogs and sniffer dogs.

In 1975, Mr. St‑Pierre built a kennel in Sainte‑Madeleine. He spent most of his time training dogs. One day, a friend who worked as an orientation and mobility teacher at the Nazareth and Louis Braille Institute asked Mr. St‑Pierre for advice about the behaviour of a guide dog from the United States. Back then, there were no francophone guide dog schools in Canada. Éric St-Pierre quickly realized that these dogs were not raised or trained in conditions that worked in Quebec. He realized that there was also a language barrier limiting many people's access to the services of these dogs. He therefore promised the institute that he would train dogs for them, and that is how Mira came to be. It was the first francophone centre for guide dogs in Canada.

Mira was founded in 1981. It is a non-profit organization that provides free guide dogs and service dogs to people with visual or mobility impairments, as well as to young people with autism spectrum disorder.

All of Mira's services and activities are based on the principle of body equality, meaning that what is accessible to everyone must also be accessible to people with disabilities. Within this framework, the organization's mission has the following objectives: increase the autonomy and promote the social integration of people with disabilities through the use of guide dogs and service dogs; provide services freely to all beneficiaries, regardless of their income; improve the mobility and orientation of people with disabilities so that they can move about freely in their daily lives; create an individual intervention plan adapted for each beneficiary that takes into account the beneficiary's level of autonomy, social and professional context, and mobility needs; and promote the benefits of service dogs in public places, in schools and on public transport.

Mira is known for its innovative programs, dog training techniques and fundraising activities. Since it was created, Mira has provided more than 3,700 dogs free of charge to people living with one or more disabilities. Much of this success is due to public support and concern. Without this help, Mira would not be what it is today.

I am now going to talk about two people I knew well and who lost their sight because of macular degeneration and diabetes. When I was finishing high school, a friend of mine found out that in a few years she would lose her sight to a genetic disease, early-onset macular degeneration. Diane Lamarche had a bright future ahead of her. She was a serious student who got good grades in high school. She enjoyed walking, basketball and tennis. She was also an avid reader.

We got to know each other better when we worked together as playground monitors in Lebel‑sur‑Quévillon. In our senior year of high school, she told us that she was losing her sight and that she was already learning Braille. The news left us gutted. She was so young, and had such a promising life ahead of her as an adult.

Our eyes and vision are indispensable for acquiring information from our external environment. They make it possible to coordinate all our movements, in particular those of our hands. Vision has three roles: perceptual, sensory and cognitive.

Another person who was even closer to me, my uncle Germain Boyer, lost his vision in his 70th year because of his diabetes. I remember that he enjoyed Yule logs so much that he would stock up every year. He has since passed away, but I will always remember his kindness and cheerfulness. I want to send my love to my aunt Denise and my cousins Sylvain and Mélanie in memory of him.

Ultimately, prevention remains an effective way to avoid vision loss, unless it is caused by macular degeneration, poor health or genetics.

If passed, this bill will help ensure better eye health and better vision for Quebeckers and Canadians.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, it is a great honour to stand in this House today and speak in support of Bill C-284, an act to establish a national strategy for eye care. I am proud to say that New Democrats will be supporting this bill and, in fact, as I will point out in my remarks, this is something we have been championing since the 1960s.

This legislation, in general, would provide for “the development of a national strategy to support the prevention and treatment of eye disease to ensure better health outcomes for Canadians.” The bill states:

The national strategy must describe the various forms of eye disease and include measures to

(a) identify the training, education and guidance needs of health care practitioners and other professionals related to the prevention and treatment of eye disease, including clinical practice guidelines;

(b) promote research and improve data collection on eye disease prevention and treatment;

(c) promote information and knowledge sharing between the federal and provincial governments in relation to eye disease prevention and treatment; and

(d) ensure that Health Canada is able to rapidly consider new applications for treatments and devices used for macular degeneration, cataracts, glaucoma and diabetic retinopathy.

This legislation would also designate the month of February as age-related macular degeneration awareness month.

I want to pause and thank my hon. colleague from Humber River—Black Creek, who has been an energetic, spirited and passionate sponsor of this bill. It would not be right to proceed any further without noting her energy and great work in promoting this overdue policy.

Eye health has been underfunded and deprioritized in Canada for too long. As a result, millions of Canadians are being put at unnecessary risk of vision loss because they lack access to eye care. A national strategy on eye care would ensure better access, better outcomes and quality of life for Canadians. It would also support Canadian leadership in vision research that can be exportable to the world.

Canada's New Democrats believe that our public health care system should cover us from head to toe, and that includes comprehensive eye care. Currently, access to eye care varies widely from province to province, resulting in variable health outcomes and exacerbating inequalities in our health care system. Over eight million Canadians are living with an eye condition that puts them at significant risk of blindness. An estimated 1.2 million Canadians are currently living with vision loss, with many facing a lack of investment in services and supports that impacts their living life to its fullest potential. That number is expected to grow to two million people by 2050. It underscores the need and the appropriateness of acting now so that we can arrest that alarming development.

The leading causes of vision loss in Canada are the following: Cataracts affect some 3.5 million people; age-related macular degeneration, 1.5 million people; glaucoma, about 300,000 people; and diabetic retinopathy, almost a million people or some 800,000.

Routine eye exams play a crucial role in the prevention of vision loss. If certain eye diseases are diagnosed early enough, they can be effectively managed through different invasive measures and before expensive and more invasive procedures are required. According to a recent report by Deloitte, the cost of vision loss to our economy, both directly and indirectly, was some $33 billion in 2019. That is projected to grow to some $56 billion by 2050.

If diagnosed early and if people have access to regular screening and treatment, most vision loss can be prevented: in fact, in about 75% of cases. Seventy per cent of existing vision impairment in Canada is estimated to be correctable with prescription glasses. The sizable proportion of correctable vision impairment is related to the barriers to access to vision care in Canada. Most guidelines recommend having an eye exam once a year for people aged six to 18 or 65 and older, as well as for those with diabetes or with an existing eye disease. For healthy people aged 19 to 64, one visit per two years is considered sufficient. However, this very basic diagnostic health need is not being met.

I will give a few examples. Starting September 1, free annual eye exams paid for through the Ontario health insurance plan will no longer be available to seniors. Manitoba and Nova Scotia currently only insure eye exams every 24 months for every senior, which is twice as long as is recommended. Millions of Canadians without extended health benefits do not have their eyes checked or cared for, due to cost.

As I said, the NDP has been advocating for universal public optical treatment since its founding convention in 1961. I am going to quote from that convention, which reads, “Believing that a country's most precious possession is the health of its citizens, the New Party will introduce a National Health Plan, providing benefits to those who need them without regard to their ability to pay. The plan will cover a full range of services: medical, surgical, dental and optical treatment, as well as prescribed drugs and appliances.”

It is a little over 60 years since that statement was made, and here we are in a G7 country and we are not making sure every citizen can get their eyes checked every year, never mind have the relatively inexpensive correction done that would prevent them, in many cases, from getting vision loss and even blindness. That is a national shame and it is time it was rectified.

More recently, the NPD's 2019 election platform committed to achieving head-to-toe public health care for all Canadians, and we specifically included eye care. In the 2021 platform, we committed to a long-term path to providing public coverage for eye care, along with other health services. In May 2021, the New Democrat member of Parliament for Algoma—Manitoulin—Kapuskasing, who I note is in the chair today, introduced Motion No. 86. That motion called on the federal government to work toward the creation of a national strategy for action on eye health and vision care. One can see not only that our support for this bill is there because of the need and the overdue nature of this, but that New Democrats have been playing a key role in placing this issue on the national agenda for decades.

I have to point out where the Government of Canada has simply failed to meet its commitments in this regard. In 2003, the Government of Canada made a commitment to the World Health Organization to develop a vision health plan for Canada by 2007 and to implement that plan by 2009. To date, no plan has been developed.

As recently as July 2021, the Government of Canada voted in the UN General Assembly for the first agreement to be adopted at the United Nations designed to tackle preventable sight loss and ensure that eye health is part of the United Nations sustainable development goals. In this resolution, the establishment of a national vision health plan was endorsed again by Canada.

As much as I credit the hon. member for taking this overdue measure, one has to wonder why this had to take the form a private member's bill, why the government is not meeting its own obligations and why it is not actually introducing government legislation using the full force of its control of the Order Paper to meet its own commitments, which it has made not only to Canadians but on the world stage.

It is important to note as well that this legislation has the support of stakeholders across this country. Several organizations, including Fighting Blindness Canada, the Canadian Council of the Blind, the Canadian National Institute for the Blind, Vision Loss Rehabilitation Canada, Diabetes Canada, the Canadian Association of Optometrists, the Canadian Ophthalmological Society and the Canadian Association of Retired Persons, have all advocated for a national eye care strategy for many years.

I want to pause for a moment to talk about the particular impacts this has on marginalized groups, including its gender impacts. When gender differences limit access to proper eye care services, women are at greater risk of developing eye diseases that are otherwise treatable and preventable. Recent studies published in The Lancet Global Health in 2020 revealed that women carry the greater burden of visual impairment globally. More women than men have impaired vision due to cataracts, age-related macular degeneration and dry eye disease. One in four women is at risk of vision impairment, compared to just one in eight men.

I will conclude by thanking the hon. member again for introducing this bill and let her know that the NDP will enthusiastically support it at all stages.

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I am happy to rise today to speak in support of Bill C-284, an act to establish a national strategy for eye care, presented by my friend and colleague, the hon. member for Humber River—Black Creek. I know this is something the member has been working on for quite some time and I would like to recognize her extensive work on this issue.

This piece of legislation would not only ensure better health outcomes for Canadians, but also recognize the month of February as Age-Related Macular Degeneration Awareness Month, bringing awareness to the leading cause of vision loss in people 50 years or older.

More than eight million Canadians are presently living with one of the four common eye diseases and more than one in 10 older adults have some degree of vision loss, which places them at serious risk of losing their vision. Vision loss can be harmful to many elements of daily life, impacting the way a person works, participates in activities and interacts with the world around them. That is why it is our duty to take proactive measures to prevent and treat these diseases effectively.

Routine vision care can help to reduce the risks of blindness and vision loss later in life and improve the outcomes associated with eye diseases like cataracts and glaucoma. Unfortunately, the COVID-19 pandemic worsened the issue of vision loss in Canada as eye surgeries were cancelled or delayed and wait times to see vision care providers also increased over the course of the pandemic. That is why a national strategy—