Evidence of meeting #37 for Health in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was drug.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

  • Richard Chisholm  President, Canadian Anesthesiologists' Society
  • John Haggie  President, Canadian Medical Association
  • Gail Attara  Chair of Operations Committee, President and Chief Executive Officer, Gastrointestinal Society, Best Medicines Coalition
  • Suzanne Nurse  Representative, Best Medicines Coalition
  • Diane Lamarre  President, Ordre des pharmaciens du Québec
  • Myrella Roy  Executive Director, Canadian Society of Hospital Pharmacists

10:20 a.m.

Conservative

The Chair Joy Smith

Thank you very much.

We will now go to Mr. Strahl.

March 29th, 2012 / 10:20 a.m.

Conservative

Mark Strahl Chilliwack—Fraser Canyon, BC

Thank you very much. Thank you to everyone for being here on a very important issue.

I don't know who to throw this question to. Numerous witnesses have referenced different countries and their responses.

I guess I will ask a very direct question. Are you aware of any countries in the developed world, perhaps the G-7, that are not experiencing drug shortages or the threat of drug shortages? Does anyone know of any?

10:20 a.m.

Conservative

The Chair Joy Smith

Who would like to answer that?

10:20 a.m.

President, Canadian Anesthesiologists' Society

Dr. Richard Chisholm

I have talked to colleagues in anesthesiology from Britain, Australia, New Zealand—some of them are a little outside of the G-7, I realize. They do not have the problems we have or our American colleagues seem to have had. They smiled and said they had a little bit of a blip two years ago and it was addressed by their central agencies.

It hasn't been a problem. They seem to source a lot of their medications in Asia and get them there. The Brits just don't seem to have a problem.

10:20 a.m.

Conservative

Mark Strahl Chilliwack—Fraser Canyon, BC

You identified two countries that have a central health care delivery system, with one level of government essentially overseeing the system, that have been able to avoid this problem.

10:20 a.m.

President, Canadian Anesthesiologists' Society

Dr. Richard Chisholm

That appears to be the case, yes.

10:20 a.m.

Conservative

Mark Strahl Chilliwack—Fraser Canyon, BC

Do we know of any multi-jurisdictional countries with states or provinces that also have a role in delivering health care that haven't experienced this problem? If Britain and New Zealand are the examples, do we know of any with a similar system to Canada that haven't experienced a similar problem?

10:20 a.m.

President, Canadian Anesthesiologists' Society

Dr. Richard Chisholm

I believe Australia has a series of states. I'm not exactly sure how their health system is set up, but they too have not had a problem.

10:20 a.m.

Conservative

Mark Strahl Chilliwack—Fraser Canyon, BC

Thank you.

10:20 a.m.

Conservative

The Chair Joy Smith

Ms. Lamarre.

10:20 a.m.

President, Ordre des pharmaciens du Québec

Diane Lamarre

I do believe, however, that no country has experienced as widespread of a shortage as what Canada is going through. Right now, injectable drugs are severely affected in Canada. I believe it is incumbent upon us to learn from this specific case. I think it is in our best interests to show others the way. Despite dual legislation, I think the responsibilities and oversight are shared, and lessons must be drawn when it comes improving our processes.

Health Canada's special access program is a federal initiative that has never been tested in a shortage situation like the one we are in right now. It has always applied to rare situations, for patients who needed a drug with limited or no availability in Canada. A doctor would request it for a patient. This is the first time a group of doctors has needed a wide range of drugs for a group of patients. This is a first that we must learn from.

When the special access program was launched, it met certain needs. We are realizing that those needs are going to be felt again, unanimously around the world. I think that what we are experiencing should guide us in changing existing structures so we are better equipped to respond to needs quickly and much more appropriately. As it stands, the special access program has made it possible to import drugs more quickly for a large number of patients and in large quantities, and that is a first.

10:20 a.m.

Executive Director, Canadian Society of Hospital Pharmacists

Myrella Roy

I think I'll restate what I said before. We're health care practitioners. We're not fully familiar with how all the political systems work and how the health care systems work around the world. That is Health Canada's responsibility. If there are solutions and there are other countries that have systems similar to ours and we can learn from their system, that is what we expect Health Canada to do.

10:25 a.m.

Conservative

The Chair Joy Smith

Thank you, Mr. Strahl.

Mr. Morin.

10:25 a.m.

NDP

Dany Morin Chicoutimi—Le Fjord, QC

Thank you, Madam Chair.

First off, I want to offer a special thanks to my colleague Anne Minh-Thu Quach for being the first member of Parliament to raise the drug shortage issue involving Sandoz in the House of Commons. I am proud to belong to a party that sees drug shortages as important and one that shows leadership.

Ms. Quach then addressed a question to the Parliamentary Secretary to the Minister of Health, Mr. Carrie. He replied that he would see to it that the appropriate information was provided to the right people at the right time and that, as a result, doctors, pharmacists and patients would be informed of what was happening with enough advance notice to adjust treatments if need be. That was his reply. If I go by that, I am inclined to think that the government is showing leadership, although everything you have said suggests that the federal Conservative government has failed to show any leadership in this matter.

Furthermore, Ms. Lamarre, I was quite struck by something you said: between 2006 and 2010, shortages had quadrupled. You even said the most recent shortage was widespread. That is disturbing, indeed.

I want to pick up on what my colleague Libby Davies pointed out. In 2008, the industry minister, Tony Clement, was made aware through a report by the Competition Bureau. In 2011, the Canadian Anesthesiologists' Society also contacted the Minister of Health, Ms. Aglukkaq, who has been on the job for four years. Unfortunately, raising the matter with cabinet or even Ms. Aglukkaq's office does not do any good. I agree with you, the government is failing to show leadership on this issue, and I find that appalling.

What's more, as Dr. Haggie mentioned, the current government prefers to point the finger at the provinces. Ms. Leitch, a Conservative member, repeated that position today. She blamed health professionals for not monitoring the situation, and the provinces, saying it was their problem.

What it boils down to, in my opinion—and I would like Dr. Haggie to comment on this—is a lack of leadership by the federal government and a passing of the buck to the provinces. It is already common knowledge that there is a doctor shortage in the provinces, at least in Quebec, and given the scarce drug supply, some treatments and surgeries are being delayed. Provincial wait times to see a doctor and receive treatment for a variety of conditions will increase. So that will be the provinces' problem, not the Government of Canada's. I am appalled by this lack of leadership. I want to hear your thoughts, Dr. Haggie, on what I just said.

10:25 a.m.

President, Canadian Medical Association

Dr. John Haggie

Looking at it from a patient's perspective, they don't have a grasp of the niceties of jurisdictional disputes. They really don't understand how it is that the drugs they get actually get to them. To be perfectly honest, before these last few weeks, I was pretty well completely ignorant as well. I'm not sure I'm any wiser now, because what this whole exercise has highlighted to me is that there isn't a seamless approach to health care. There isn't a seamless approach to the issue of pharmaceuticals.

You could almost argue that pharmaceuticals now are the defining modality of medical management. When I trained, we were on the end of fixing things surgically. Diseases I treated with a knife, as a resident, are now treated medically, for the benefit of the vast majority of patients. Drugs are no longer just one of those things that are there as an optional extra.

I turn it back from the patient's point of view and say that the constitutional debate, the funding debate, the financing debate between health boards, provinces, and the national group has not informed them. It has not made them feel comfortable. It has not made them feel as though things are moving in the right direction. Finger pointing and blame....

You need to learn from case studies, and where you stand on that depends on where you sit, quite frankly.

As Rick Hillier, another Newfoundlander, said, no good crisis should go to waste. The one good thing that could come out of this is that we can do it a hell of a lot better next time and we won't end up in this pickle in the future. If that requires that the feds and the provinces and the territories sit down together and actually talk to each other, is that such a bad thing?