Mr. Speaker, when the federal, provincial and territorial health ministers announced the formula they had decided upon to provide assistance to hepatitis C victims, they did not do so lightly. Much thought had been put into it. They looked at the moral, systemic and human implications, but only after careful consideration did they reach a decision. There were indeed many aspects to take into consideration.
We must recognize that, unfortunately, today still too little is known about hepatitis C. Even if the scientific community is doing its best to keep expanding the knowledge base, we are still at a stage where we cannot even predict with any certainty how an infected person may react.
We know that hepatitis C is very different from HIV, although both can be transmitted through the blood. People with hepatitis C are not sentenced to die, and many continue to lead a completely normal, functional life without feeling any debilitating effect.
So, we are now able to identify the virus much better than before and the accuracy of screening tests is improving by the day, which makes the blood supply system increasingly safe. But we are always seeking to know more.
We have looked to other countries to see if we could learn anything from them. We have looked at what they have done to resolve hepatitis C problems caused by their own blood supply system. We did not learn much in the end.
We have found that, while most countries had made similar decisions under similar circumstances with the tragic results that we know, most did not take the same approach we took. We in Canada have taken action to prevent any harm to our fellow citizens that we could prevent, and we did so cautiously in consideration of all that was involved.
Canada was recently compared to other countries for its approach to resolving the hepatitis C crisis. I can think of Ireland in particular. In recent years, Ireland introduced its own assistance plan for hepatitis C victims.
Health Canada officials travelled to Ireland to see how the Irish proceeded, and to understand why and how that formula was adopted. They found that the Irish formula was tailored to Ireland's very specific circumstances, and that it would not suit Canada's circumstances.
The hepatitis C tribunal was set up in Ireland after some 1,500 young mothers contracted the disease, in the seventies, when they were given a blood product called anti-D, which had been exposed to hepatitis C, although at the time hepatitis C was still unnamed and was called non-A and non-B hepatitis.
The anti-D product was used as a preventive treatment for new mothers and thus caused harm, even though it had been used without serious problems for quite a while. Most of the cases can be traced back to a unique plasma donor, making it clear that the blood in question should never have been used.
Many people infected with the anti-D product continued to give blood, since they had no reason to change their habits. This led to even more people being exposed through the blood supply system.
So, another blood supply system from another country also experienced problems of its own. The formula used by Ireland regarding its blood supply problems is quite specific, so much so in fact that no other country has used it.
Looking back at what we did based on what we now knowwe reviewed the blood system that Canada had in the eighties. We concluded that various measures could have been taken to avoid hepatitis C cases. We looked at what was done in the United States, even though most of the other countries were in a situation similar to ours. If we could turn back the clock, I do not think anyone would adopt the risk management method Ireland did in connection with its blood system.
Ireland was far slower to adopt international scientific risk management methods in connection with its blood system. Moreover, many western countries, including Canada, adopted that system.
Although Ireland never inaugurated the indirect screening test, that country's blood inquiry tribunal never faulted it for not doing so. Had Canada followed the Irish risk management method, it would have inaugurated the specific Hepatitis B screening test a year and a half later than it did. There would have been even more cases of infection. This is precisely what happened in Ireland.
Care must, therefore, be taken when seeking examples to follow. The two types of government activity, the concern for health and safety as opposed to the compensation of people let down by the health system call for two very different types of comparison. The scientific community constantly distributes information on the international level.
We could have followed the US example in 1986, but we did not, nor did most other countries. Normally, issues such as public health, and more specifically the monitoring of diseases and safety, are addressed from a totally different perspective, for instance, than health care, which is generally based on a national vision.
It is therefore far more common for a national government to follow international scientific models than any other type of policy or initiative from some specific society, which reflects that society's specific history and way of looking at things.
We quickly understood that the situation had to be addressed within the Canadian context and that we could not simply apply policies from elsewhere and expect them to work here.
Should we copy the policies and methods of another country, especially when we have no guarantee they would be really effective here?
It is often said that social programs are not easily exported. Canadians continue to say they do not want a health care system like that of the United States, and President Clinton learned a few years ago himself that Congress had reservations about a single-payer universal health care system.
I say that because there are limits to the types of comparisons that can be made between Ireland and Canada, their system of health care and their way of dealing with the damages caused by the blood system. Sometimes it is useful to make international comparisons, but more often than not, it is not appropriate.
When the Canadian ministers of health announced that they wanted to settle claims for compensation by victims of hepatitis C, I pointed out that it would be a reasoned approach. This approach led us to concentrate on the period between 1986 and 1990.
Given that, in all fairness, we must not make a distinction between the harm done by the blood system and other types of harm caused by the Canadian health care system as a whole, a problem of this magnitude warrants thorough debate and, to be quite honest, I do not think such a debate has been held yet.
