House of Commons Hansard #35 of the 41st Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was wheat.

Topics

Breast Density Awareness Act
Private Members' Business

11:05 a.m.

Conservative

Patrick Brown Barrie, ON

moved that Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue, be read the second time and referred to a committee.

Mr. Speaker, I am very pleased to speak to my private member's bill, Bill C-314, An Act respecting the awareness of screening among women with dense breast tissue, which calls on the federal government to encourage the use of existing federal initiatives in order to increase awareness among Canadian women about the impact of having dense breast tissue and the complications it poses for breast cancer screening.

Breast cancer touches many Canadian women and their families and friends, and is the most common form of cancer in women. I know this is something Canadians from coast to coast to coast care deeply about. Just last month Barrie held its annual CIBC Run for the Cure in support of breast cancer research. I saw 2,000 residents out early on a cold and wet Sunday morning to support the battle against breast cancer. Runs like that occur across the country because Canadians are deeply concerned.

In my community of Barrie, in less than 12 months, the Royal Victoria Hospital's regional cancer care centre will open. There have been literally thousands of fundraising events over the last five years to support this very large cancer centre. It will help battle a variety of cancers, including of course, breast cancer.

This year it is estimated that about 23,000 women will be diagnosed with breast cancer, and 5,000 women will die from this insidious disease. Over their lifetime, one in nine women will be diagnosed with breast cancer. This is very difficult to accept. It touches many women and their loved ones. Sixty-four Canadian women will be diagnosed with breast cancer and 14 will die of breast cancer every day. It is my sincere hope that over time this bill will help reduce those troubling numbers. Health sectors in other areas of the world are beginning to more aggressively target dense tissue to enable early detection of breast cancer.

It is important for all of us to be aware of the fact that screening for breast cancer can save lives. Providing women with accurate information about screening will help them make decisions that are right for them. The federal government supports a number of initiatives to support Canadians dealing with cancer.

Bill C-314 aims to raise awareness about dense breast tissue and breast cancer screening. It will help women and their doctors make well-informed decisions regarding breast cancer screening. It includes a number of elements, which I will briefly outline. I will also address initiatives currently under way to address them.

First, this bill requires the Government of Canada to assess whether gaps in information exist relating to breast density in the context of breast cancer screening. Second, this bill requires that approaches be identified, where needed, to improve information for women in order to: one, address the challenges of detecting breast cancer in women with dense breast tissue; and two, raise awareness concerning these challenges. Third, the bill requires the existing Canadian breast cancer screening initiative to share information on dense breast tissue and its relationship to breast cancer screening and any follow-up procedures that may be deemed necessary.

Canada is fortunate to have screening programs for breast cancer. The provinces and territories deliver these programs to detect breast cancer before it has spread so that treatment can be started. We are learning more and more from scientific research about breast cancer and its risk factors. New and better treatments are being developed. However, there is still much to learn. We know that good information is fundamental to the decisions that each of us makes with the advice of our doctors about our own health. This dialogue is the key to doctor-patient relationships.

Let me take a few moments to explain how the issue of breast density relates to breast cancer screening. First, breast density refers to the amount of tissue in the breast. Dense breasts have more tissue. Breast cancer screening is done using a mammogram, which is an X-ray of the breast. A woman's breast density can affect the accuracy of a mammogram and it may be more difficult for a doctor to see an abnormality. There could be cancer present if the breast tissue is dense because both cancer and dense breast tissue appear white on mammograms.

High breast density is also linked to an increased risk of developing breast cancer, although it is not yet known why this is the case. We also do not know how common dense breast tissue is among Canadian women, although some statistics point to the fact that it could be as high as 40%. Providing women with information of what is known about breast density would help them make well-informed decisions about screening and would open the door for women to engage in follow-up procedures, such as an MRI or ultrasound, if they have dense breast tissue which could skew the mammogram.

In addition to raising awareness on breast density, the bill recognizes the responsibility of the provinces and territories for providing breast cancer screening. Provincial and territorial breast screening programs are invaluable in the early detection of breast cancer in Canadian women.

As noted in the bill, the federal government plays a role in breast cancer screening by facilitating the identification and adoption of effective practices in screening. We also support the sharing of information on screening methods and outcomes through our federal roles in research and surveillance.

Through the Canadian Institutes of Health Research, our government provides funding to researchers to investigate the full spectrum of cancer prevention and control. One of the priorities of the Canadian Institutes of Health Research is early detection of cancer. The CIHR works with partners both nationally and internationally to advance its research priorities, including breast cancer research.

Our government has demonstrated its commitment to breast cancer screening by investing in the Canadian breast cancer screening initiative. We work with provincial and territorial governments to measure the performance of breast cancer screening programs across Canada. This means that all jurisdictions regularly share information on the screening programs and discuss what they are learning. They share best practices, discuss the challenges they are facing and the questions that are important to all of them.

Information sharing about ways to improve these programs ensures that women receive the full benefits of early detection. This includes providing women with information about all aspects of breast cancer screening. The federal, provincial and territorial national committee for the Canadian breast cancer screening initiative provides opportunities for provincial and territorial governments to work together to develop their screening recommendations and approaches. This committee is comprised of medical professionals and key stakeholders.

For example, the committee is currently looking at breast cancer mortality and improving screening for underserviced populations. We have the Canadian breast cancer screening database, which is a source of valuable information on breast cancer screening. Participating provincial and territorial screening programs contribute to the national database, which is used to monitor and evaluate breast cancer screening programs. Non-government organizations play a vital role in this process as well.

I am proud to say that our government is taking action on cancer through our continued investment in the Canadian Partnership Against Cancer which has led to the implementation of the Canadian strategy for cancer control. The partnership is the first of its kind and was established by our Conservative government. It covers the full spectrum of cancer control, from prevention to palliative and end-of-life care, policy to practice, and from research to health system applications.

Together with the cancer community, the partnership is accelerating the use of effective cancer prevention and control strategies. Its objectives are to reduce the number of cancer cases, minimize cancer-related deaths and improve patient quality of life.

In March of this year, our Prime Minister announced renewed funding of $250 million over five years, beginning on April 1, 2012. This will allow the partnership to continue its invaluable work. In the words of the Prime Minister:

We are making progress on prevention, diagnosis, treatment and hope, and in tracking our progress closely, the partnership is leading us on the path to a cure.

The partnership plays a key role in providing information to women on cancer screening, which aligns with the spirit of this bill. The bill also recognizes the important role of organizations such as the Canadian Cancer Society and the Canadian Breast Cancer Foundation in providing reliable information that supports women in making decisions about their health.

All of us are familiar with the Canadian Cancer Society. This national volunteer organization works in cancer prevention, research, advocacy, information and support for all cancers.

The Canadian Breast Cancer Foundation is a national volunteer organization dedicated to working toward a future without breast cancer. The foundation funds, supports and advocates for research, education and awareness programs, early diagnosis and effective treatment, as well as a positive quality of life for those living with breast cancer.

Women's health organizations, such as the Canadian Women's Health Network, raise awareness on many health issues faced by women in Canada, including breast cancer.

Working with the above-listed breast cancer stakeholders, the federal government will continue to raise awareness through existing initiatives on the issue of breast density in the context of breast cancer screening. These stakeholders will be very critical in our battle to raise awareness about breast density.

This bill is particularly timely given that October is breast cancer awareness month. Through efforts to raise awareness, Canadian women and their families can become more informed about breast cancer. They will learn about breast density and its implications for breast cancer screening. They will be able to make well-informed decisions based on this knowledge.

I would like to thank Andrea Paine at the Ministry of Health in Ottawa, Dr. Rob Ballagh of Barrie, Mike Richmond from Toronto, and my assistant in Barrie, Shawn Bubel, for their assistance in the drafting of the bill.

The bill provides an opportunity for the Government of Canada and the House to recognize the critical importance of raising awareness about breast density and breast cancer screening.

It would be an honour for me to have the support of all members in the House for this bill. Too many families have been touched by this form of cancer. I am hopeful that by ensuring women get the information they need which could lead to early detection, this legislation could potentially save lives.

Breast Density Awareness Act
Private Members' Business

11:15 a.m.

NDP

Anne Minh-Thu Quach Beauharnois—Salaberry, QC

Mr. Speaker, first, I would like to congratulate my colleague opposite for his interest in and his work on the fight against breast cancer, particularly cancer in those with dense breast tissue.

To promote breast cancer awareness and prevention, should the government not work with the provinces and territories to reduce the wait times for diagnostic tests and improve access to X-rays in the public health care system?

This would give disadvantaged women better, earlier and fairer access to the breast cancer screening program, since diagnostic X-ray testing is sometimes carried out in private clinics.

Breast Density Awareness Act
Private Members' Business

11:15 a.m.

Conservative

Patrick Brown Barrie, ON

Mr. Speaker, I am very proud that this government has worked closely with the provinces and territories to assist in enhancing health care in Canada. Let us not forget that this is the highest level of health care funding in our history to the provinces and territories through this federal government. With an increase of 6% a year we have seen record investments in health care in all areas.

The bill sets out that we would work with the provinces and territories on enhancing the breast cancer screening protocols. I am very proud of what this government has done on health care. It is not limited just to the support for the provinces and territories in this new investment, but with the Canadian cancer partnership and a variety of other partnerships this government again and again does whatever it can to enhance health care in Canada.

Breast Density Awareness Act
Private Members' Business

11:15 a.m.

Conservative

Cheryl Gallant Renfrew—Nipissing—Pembroke, ON

Mr. Speaker, the recommended initial age for breast screening as well as the frequency for screening changes from study to study. It also changes from province to territory.

How does a woman know that she is getting the initial screening and the frequency of screening according to need as opposed to according to what a province or territory wants to pay for?

Breast Density Awareness Act
Private Members' Business

11:15 a.m.

Conservative

Patrick Brown Barrie, ON

Mr. Speaker, that is one of the benefits of the bill. It encourages the sharing and pooling of information. There is a variety of standards, but now with the provinces, territories and the federal government working on the Canadian breast cancer screening initiative, we will start to see more of a balance in terms of protocols.

I also note that the Government of Canada is investing in the CIHR for breast cancer screening. The CIHR has made that an area of interest. There are a lot of things we do not know in terms of breast cancer. That is why the research done by the CIHR is critical, as is having an active dialogue with the provinces, territories and the federal government on breast cancer. Research and surveillance are going to be very much needed as we embark on this battle against breast cancer.

Breast Density Awareness Act
Private Members' Business

11:20 a.m.

Conservative

Ron Cannan Kelowna—Lake Country, BC

Mr. Speaker, I would like to thank the hon. member for Barrie for bringing this very important issue to the House. I have three adult daughters. My wife and I were talking about this the other day because of the CIBC breast cancer walk. It is phenomenal to see the number of women who have been able to be screened and have mammograms, and have moved into a new kind of life because of breast cancer.

Why has this not taken place already? Why has it come to this stage? We know there is so much information available. Maybe he could enlighten us as to why it is at this stage and what the process is to get this legislation through the House.

Breast Density Awareness Act
Private Members' Business

11:20 a.m.

Conservative

Patrick Brown Barrie, ON

Mr. Speaker, we are learning more and more about breast cancer all the time. While it was not clear before, I know that in the U.S. and a few other jurisdictions they realized there were challenges with the screening due to the fact that dense breast tissue was skewing mammogram results. Possibly as high as 40% of females have dense breast tissue, which is a huge per cent of the population that we would have inadequate information on from a mammogram. Other health care jurisdictions are embarking on new screening initiatives, and this is an opportunity for us to learn from each other. Adopting more effective practices would be a very positive step for the Canadian fight against breast cancer.

In terms of why this is has not happened before, it is just that we had not learned about it before. This is something that Health Canada was looking into and it is something that was only started last year in the United States. This is something that was identified as a potential area where we could improve breast cancer screening. It is certainly worthy of the House to look into, if it could potentially save lives of 23,000 females who are, unfortunately, diagnosed with breast cancer every year.

Breast Density Awareness Act
Private Members' Business

11:20 a.m.

NDP

Anne Minh-Thu Quach Beauharnois—Salaberry, QC

Mr. Speaker, breast cancer is one of the most common illnesses among Canadian women. In 2011, an estimated 23,000 women will be diagnosed with breast cancer, and more than 5,000 women will die of it. On average, 64 Canadian women a day learn that they have breast cancer.

A breast cancer diagnosis forever alters the lives of these women. First, there is the fear and anxiety that accompanies the tests, and then chemotherapy becomes a part of their everyday lives. They must miss work and find someone to help take care of their children. Sometimes, a diagnosis can mean surgery and the loss of a breast, along with all of the pain associated with that harsh reality. There is also the exorbitant cost of medications and the red tape of insurance companies. And then there are the women who have no insurance at all and must make sacrifices to get the essential medications they need to fight this illness.

Women need support for the duration of this process. I would like to acknowledge the initiative of the member for Barrie. It is remarkable that a man, who will probably never suffer from this disease, wants to get involved. However, this bill is incomplete. It is but a modest band-aid solution to a serious and complex disease. This bill would encourage the use of existing initiatives. In my opinion, we must do more. Although breast density may be a significant risk factor, it is nevertheless just one factor to be taken into consideration.

First, what is breast density? The member opposite explained it very well. Dense breasts have more connective tissue, glands and ducts. When a woman has a mammogram, the dense tissue appears white, the same colour as cancerous lumps, which can result in a false diagnosis. Other, more precise tests are then recommended. Better results are obtained for these women with magnetic resonance imaging, for example.

However, we must be cautious. Breast density only affects a small number of women. Focusing only on this aspect of the disease will not help improve cancer screening throughout Canada. This bill abandons all other women, the majority, who need better screening and health care measures. I would like to explain what would really make a difference in the fight against breast cancer.

First, the reality is that many women will not discover in time that they have breast cancer, simply because they do not have access to a family doctor, who is often the first contact in the health system. The family doctor knows the patient's history, weight and general health, and asks questions about the patient's lifestyle, nutrition, and so forth. The family doctor does the annual exam and may detect symptoms of the disease or an unusual lump in the breast. He or she may refer the patient to a specialist for tests and further investigation.

More than 5 million Canadians still do not have a family doctor. For years, the people of this country have been calling on governments to address the shortage of doctors. What is the federal government doing? Nothing. My colleagues and I have proposed numerous measures to fix this important issue. One significant way to help would be to work with the provinces to increase the number of spaces in universities in order to train an additional 1,200 doctors. Multidisciplinary teams should also be established to improve screening and patient care.

For example, at the Centre hospitalier de l'Université de Montréal, general practitioners, oncologists, nurses and radiologists work together to treat patients. Early detection has increased because there is constant communication between the various health professionals. In addition, treatment includes psychological services as well as support for relatives.

Second, breast cancer screening is not routine in Canada. Programs are sometimes inadequate or completely non-existent, as is sadly the case in Nunavut. However, specialists are telling us that the earlier the diagnosis, the higher the woman's chances of survival. Studies have shown that women are at a higher risk of developing the disease after the age of 40. The Province of Quebec implemented a routine screening program a few years ago. The program targets women between the ages of 50 and 69, and involves getting a mammogram. Every two years, women are contacted by the department and are encouraged to get tested. The program is fully covered by the Régie de l'assurance-maladie du Québec. According to statistics from Quebec's Department of Health and Social Services, breast cancer mortality rates in participating women dropped by at least 25% between 1996 and 2006.

The federal government should take the lead on this and work with the provinces and territories to ensure stable funding for routine screening programs for women 40 and over. In doing so, lives would be saved.

Thirdly, another major problem is access to diagnostic tests within a reasonable timeframe. New investments in imaging equipment have increased the number of scanners available, but have not necessarily led to shorter wait times, or so says the Health Council of Canada in its May 2011 report. Between 2008 and 2010, wait times for these scans decreased in Alberta and Prince Edward Island and increased in Ontario. Governments continue to face challenges in collecting data on wait times for diagnostic imaging, in part because many scans are done outside hospitals in free-standing clinics.

There is also the question of public coverage for diagnostic testing. Some provinces cover diagnostic tests and others do not. Some provinces provide coverage at hospitals only. In Quebec, for example, tests are covered only if they are done in a hospital. Nonetheless, patients can pay out of pocket to get tested at free-standing clinics. These private-sector tests are done by radiologists who also work in public-sector hospitals, which increases the wait times and creates two classes of people: those who have the means to pay for diagnostic tests and those who do not, the less fortunate. A number of doctors in Quebec, including the MQRP —also known as Canadian Doctors for Medicare—condemn this double standard.

A federal fund for improving public coverage of diagnostic tests, included in the next health report, is certainly one solution to consider. Establishing Canada-wide standards to improve breast cancer screening for certain women, namely women with dense breast tissue, is a concrete measure that would truly help these women. Is the government prepared to commit to such solutions? I hope so.

This government has been very lax when it comes to protecting and funding the public system. Under the pretext that health falls under provincial jurisdiction, the Conservatives clearly seem to think that the best thing to do is nothing at all. However, the federal government is responsible for working with the provinces to improve the health of all Canadians. Do the members opposite need to be reminded that one of the principles of the Canada Health Act is universality. People consider equal access to health care to be a right of citizenship, not a privilege for only the most fortunate.

Fourth, the cost of medication is a serious obstacle to cancer treatment. What is the point of improving breast cancer information and screening if women cannot afford to buy the medication they need to be cured? While the health care system provides cancer-treating drugs in hospitals, half the new treatments are taken at home and patients are therefore responsible for paying for them. A lack of insurance means enormous costs for patients and their families given that the average cost of treatment for new cancer-fighting drugs is exorbitant at $65,000. Some people do not have insurance since they do not have the money to pay for a private policy.

Under the current health accord, which was signed in 2004, the federal and provincial governments agreed to create options for catastrophic pharmaceutical coverage. Since then, nothing has been done. What is the federal government waiting for to resolve this issue? Does the government have no idea how to reduce the cost of medication?

I have a few ideas. First, make better use our negotiating power when purchasing pharmaceuticals, specifically by joining with all the provinces and territories to buy in bulk. After all, there is strength in numbers. Second, reduce the administrative costs by making use of the public system. A Canada-wide catastrophic drug program would be less costly to administer than several small programs in the private sector. Third, eliminate rebates for pharmaceutical companies and pharmacists and provide funding for research based on the actual needs of the public rather than on profits for pharmaceutical companies.

Finally, breast cancer prevention could be greatly improved. This disease has many risk factors: personal and family history, obesity, and the use of alcohol and tobacco can increase the risk of breast cancer.

I hope that all these good ideas will help the members of the House to understand what a terrible illness breast cancer is. Although this bill has good intentions, it does not do enough. Nevertheless, we hope that the members opposite will propose a better and stronger Canada-wide strategy that will help all women suffering from breast cancer rather than just a few of them.

Breast Density Awareness Act
Private Members' Business

11:30 a.m.

Liberal

Hedy Fry Vancouver Centre, BC

Mr. Speaker, I rise to speak in favour of this particular piece of legislation, but I would also like to make some further comments with regard to it.

The Liberal Party supports any efforts to increase awareness with regard to illness and research, to provide more information to Canadians, and to deal with screening issues. That is a given. We all agree with that and believe we should be doing this in many other areas. There are a number of areas within health promotion and disease prevention wherein the federal government could take a lead as well as an active approach to ensure that 60% of preventable diseases are prevented. There are broader issues we should be looking at rather than this one particular issue, but it is a start.

The federal government has signed an agreement on a pan-Canadian approach to breast cancer. If the legislation says that the federal government has a leadership role to play with regard to an issue like breast cancer, then it must also look at a pan-Canadian approach to many other things.

My colleague who spoke last talked about a pharmaceutical strategy. The 2004 health accord said that we need a pharmaceutical strategy because many Canadians do not have access to lifesaving drugs and drugs required to treat chronic disease. Drugs cost a lot of money and many people cannot afford them.

We must discuss how to implement some of the really important issues in the health accord that require federal leadership. The federal government cannot say that on the one hand it wants to lead pan-Canadian approaches regarding one issue, but on the other hand it does not want to do it regarding another issue. That would not be a reasonable or logical response to anything.

There is a huge role for the federal government to play in ensuring that no matter where Canadians live in this country they have access to the health care services they require when they need them and that in many instances they have access to integrated services that would prevent them from getting diseases. That would provide huge savings to the health care system. It would also help deal with disease chronicity which would help keep people out of hospitals and increase savings and cost-effectiveness in the system.

There are many things we must talk about if we want to open the door to a pan-Canadian approach. I am glad to see that the member has brought this forward. I hope his party will listen to him. I also hope that the government will take a pan-Canadian approach toward many necessary issues.

The bill calls for the federal government to work with the provinces and territories to increase awareness among women with regard to dense breast tissue. The issue I want to flag here is that while we want to increase awareness, which is a very positive step, we also want to be careful that we do not create anxiety among women who have dense breast tissue because there is not much evidence to show that the screening detection methods such as MRIs, et cetera, will give the wanted outcome and save lives.

There is one important thing to remember in terms of breast awareness and in terms of preventing breast cancer. It is not the yearly doctor visit for a breast examination that is so important, nor is having an MRI . What is important is that a woman examine her breasts every month at the appropriate time.

Many people would ask how that monthly self-examination would help. If a woman examined her breasts monthly she would know what they normally felt like or how they felt the last time she had tests done and she was told her breasts were fine. I am not only talking about breasts. When a woman screens herself on a monthly basis she knows what is normal for her body. Therefore, any change she discovers will be a flag that something new has occurred. It may not be anything she needs to worry about but it will at least cause her to initiate a visit to her physician for investigation.

It is important for women, especially those who have dense breast tissue, to understand that self-examination is one of the most important things they can do for themselves. We can say the same thing with regard to men and testicular cancer, et cetera. Awareness is important.

I would like to see the federal government's role expanded in the bill to suggest that it could and should be a clearing house for best practices.

For instance, British Columbia has a solid record in this country for having the highest survivor rates and lowest death rates with regard to breast cancer. That is not only because of early screening but also because of an integrated approach wherein researchers and individuals dealing with genomics as well as individuals from the cancer society and the cancer agencies work together as an integrated team. It is important to emulate those best practices which give us best results. Therefore, another role for the federal government would be to take on a pan-Canadian approach by looking at some sort of clearinghouse on many issues.

Unlike the California bill, the bill does not create panic. It does not recommend that women should run out and demand MRIs or further screening. That is good because I would stress there is no evidence that this would help. However, what this bill is suggesting is important and necessary is increased awareness and discussion to help women understand what it is they need to do. Identifying gaps in information and improving information for women is and always will be a good thing.

This year 234,000 women in Canada will be diagnosed with breast cancer of which 5,100 will not survive. Those are very staggering figures. Many of these women are at the peak of their lives and may have children. It is important that they be prompted to exercise methods of prevention wherever necessary.

With regard to not causing panic, we must ensure women are aware that having access to an MRI is not an internationally based clinical guideline and that it does not create a sense of entitlement among women who have dense breast tissue that they should automatically be sent for MRIs. If that is not clear in the bill, it could create panic among these women which in turn could cause an inappropriate drain on health care system resources.

However, the bill is a beginning. If the federal government is interested in pan-Canadian approaches, which is a good idea, it is important that more research be performed to provide better information to women who are at risk of breast cancer. The Canadian Institutes of Health Research is there to increase that research. We need to work with conditions more often to determine what are best practices. It is important that the federal government accept this, follow through on it and use it as a template with regard to how it can deal with many more issues.

I go back to the 2004 accord. My colleague made the important point that parts of that accord have not received the federal leadership nor political will necessary to provide good outcomes in health care and an effective use of the system. We know the medicare system is sustainable but we must ensure there is a pan-Canadian integrated approach to provide transformative change within the system.

The bill is a start. It flags the fact the federal government cannot say that it is a provincial jurisdiction which will create a precedent for it to not only work with provincial governments but also take on political and leadership roles that will benefit all Canadians.

Breast Density Awareness Act
Private Members' Business

11:40 a.m.

Calgary Centre-North
Alberta

Conservative

Michelle Rempel Parliamentary Secretary to the Minister of the Environment

Mr. Speaker, first, I thank my colleagues for their excellent debate on this issue this morning.

I rise today to address Bill C-314, an act respecting the awareness of screening among women with dense breast tissue. I thank my colleague, the member for Barrie, for bringing this important bill forward.

As October is Breast Cancer Awareness Month, it is time to draw attention to breast cancer and to raise awareness of this important health issue affecting Canadians.

Statistics tell us that breast cancer is the most common form of cancer among Canadian women. One in nine women will be diagnosed with the disease.

Those statistics are more than just numbers. They represent women whose lives are affected by breast cancer. They are wives, mothers, daughters and friends. This year it is estimated that thousands of women across the country will be diagnosed with breast cancer and that approximately 5,000 women will die from the disease.

Thankfully research is providing answers to many questions regarding breast cancer. We are learning more about prevention, risk factors and treatments. Our government's investments into health research through the Canadian Institutes of Health Research support scientific discoveries regarding all types of cancers including breast cancer. We are learning more about the early detection of breast cancer.

The bill focuses on raising awareness regarding breast density and its effects on breast cancer screening. It emphasizes the importance of this issue in an effort to help women and their doctors make well-informed decisions with regard to breast cancer screening.

Why is that important? More than ever before Canadians are taking an active role in their health and require good information to support that role. Canadians need information on what has been proven as well as what is not yet well understood. Only then can they weigh the risks and benefits of the different courses of action.

As well, the Internet revolution allows Canadians to find a great deal of information on health topics. It also means Canadians are faced with the difficulty of deciding what is accurate, inaccurate, important or misleading.

Therefore, providing accurate information to Canadians will increase their awareness and help them make well-informed decisions.

There is a great deal of information available on breast cancer and breast cancer screening which addresses the particular issue of breast density and its implications on breast cancer screening.

A mammogram is an X-ray taken of the breast and is used as a screening method for breast cancer. However, for women with dense breast tissue it can be more difficult for this method to detect small changes that could denote cancer.

Canada's breast cancer screening programs are delivered by the provincial and territorial governments under their jurisdiction for health care delivery. These excellent programs operate according to the highest standards. The federal government is helping breast cancer screening programs through investments made in the Canadian breast cancer screening initiative. This initiative measures the performance of breast cancer screening programs across the country. The information is used by those programs to improve the services they provide to Canadian women.

We are also assisting breast cancer screening programs in sharing their best practices. A key feature of these programs is the important information they provide to women on all aspects of breast cancer screening including breast density. That way we can build on the good work that is already under way.

National non-governmental organizations and their volunteers also play integral roles in raising awareness. The bill recognizes the important role of organizations, such as the Canadian Cancer Society and the Canadian Breast Cancer Foundation, as well as numerous other women's health organizations. All of these organizations work to promote cancer prevention, early detection, effective treatments and research. They also provide education and awareness programs and work to improve the quality of life for those living with breast cancer.

The fact that so many Canadian organizations and programs already provide high quality information to women on breast cancer reflects upon the dedication that exists with regard to this enormous health challenge. Researchers, doctors, nurses and provincial and territorial cancer agencies are committed to reducing the rates of breast cancer.

Our government's investment in the Canadian strategy for cancer control and its implementation by the Canadian Partnership Against Cancer is part of this national commitment. As its name implies, the partnership is working across the country to speed up the use of effective approaches to cancer prevention and control so that all Canadians will benefit. It is helping to fill gaps, build new models and expand existing programs where needed. Cancer screening is one of the partnership's priorities and its work to provide information to Canadians is consistent with the intent of the bill. The renewed investment in the Canadian Partnership Against Cancer announced by our Prime Minister in March will help that excellent work that is under way continue.

We have much to build on and many best practices to apply as we continue to support Canadian women in accessing the information they need to make decisions on their health. Of course, our efforts are in line with the role of the federal government in supporting health research and identifying best practices in creating partnerships and of promoting the health of Canadians.

In closing, Bill C-314 encourages the Government of Canada to use existing initiatives to raise awareness of breast density in the context of breast cancer screening. This is important for Canadian women.

I sincerely hope we have the support of all members in this House for this important bill.

Breast Density Awareness Act
Private Members' Business

11:45 a.m.

NDP

Djaouida Sellah Saint-Bruno—Saint-Hubert, QC

Mr. Speaker, I would like to take this opportunity to congratulate the member for Barrie on his bill. October is Breast Cancer Awareness Month, and his bill's noble objectives are most appropriate.

On this side of the House, and I am sure on the other side as well, we recognize the impact that breast cancer has on the people of Quebec and Canada. This disease is unfortunately all too common. The statistics do not lie: one out of every nine women will suffer from breast cancer in her lifetime. What is even more tragic is that one out of every twenty-nine women will die from breast cancer. The considerable progress that has been made in recent years in research, treatment and screening has significantly lowered the breast cancer mortality rate.

Breast cancer is still too common among Canadian women. I should also point out to the House that, although it is less common, breast cancer can also affect men. An estimated 23,000 women will be affected by this type of cancer, not to mention the thousands of loved ones and caregivers who are also affected. The disease also has high social and economic costs. There are other human costs associated with this terrible disease: the loss of income can be devastating. Many couples do not survive these challenges, and loved ones become caregivers but receive little support from this government.

The bill introduced by my colleague opposite addresses a very particular issue: cancer in women with dense breast tissue. This is a real problem. Recent research has shown that dense breast tissue is a factor as important as age in the risk of breast cancer. Higher tissue density also makes breast cancer screening more difficult. During a mammogram, tumours and high-density masses in the breast both show up as white spots. It is much more difficult for women with dense breast tissue to get quick diagnoses with traditional equipment.

It is also important to bear in mind that problems linked to dense breast tissue are not likely to diminish; quite the opposite. Studies have shown a link between being overweight or obese and denser breast tissue. I do not need to remind this House that the issue of excess weight has reached epidemic proportions in Canada. We can only assume that an increasing number of women will have dense breast tissue in the near future and that this trend is on the rise.

Once again, I would like to say how much I appreciate that the member for Barrie has brought this issue forward so that we can discuss it today. Awareness is always a positive initiative. It makes women more vigilant and ensures that health care professionals are better informed. Everyone supports awareness—it is a noble objective and a just cause, but it is merely one element of treatment. In my mind, this bill is pointless. It does nothing concrete for women who have or will have breast cancer. It does not ensure better access to a health care system that is so desperately lacking in its current state.

I am a doctor myself. I decided to go into politics to make a difference. Many causes are important to me, such as the recognition of foreign credentials—which affects me personally—the status of women and immigration. But health is at the top of that list. I know that the people of Saint-Bruno—Saint-Hubert elected me because they believed in the NDP message that we will work for them. I am worried that this bill, while noble and having created the opportunity for debate, will not make a real difference in the lives of the people of Saint-Bruno—Saint-Hubert, Quebec and Canada.

One of the issues my constituents talk to me about is access to a family doctor. This bill has nothing to offer people who do not have a family doctor. This bill will not improve access to our health care system. We know that a timely diagnosis helps significantly increase the chances of survival. Without access to a doctor, many Canadians will not have access to this timely diagnosis. Wait times for mammograms are also far too long in many places in Quebec and Canada. Those are two significant factors that are not addressed in this bill that would help improve treatment, survival rates and quality of life for breast cancer survivors.

That is why the people of Saint-Bruno—Saint-Hubert voted for me. They want their daily lives to be better. They are demanding better access to health care, and rightfully so. Despite the good intentions of the hon. member for Barrie, this bill does nothing for the Canadian general public.

The hon. member for Barrie was right when he said in the preamble of his bill that the provinces are responsible for the delivery of health care. I agree with him, but I would like to remind him that he is wrong to think that his government has no responsibility in this. The federal government currently has a funding agreement with the provincial and territorial governments. Under that agreement, the different governments agreed to certain specific objectives.

This tool could be used to achieve the objectives of developing better breast cancer diagnostics and treatment for women with dense breast tissue. This is an agreement the provincial and territorial governments, including that of Quebec, signed on to. Why does the member opposite not encourage his government to get on board? We could achieve better concrete results that way.

Perhaps the member for Barrie does not believe that the 2004 health accord is the right tool to allow us to meet these objectives. If that is the case, the 2004 health accord gives his government certain tools to determine whether the accord's objectives have been met, whether the funds transferred are being used in the manner agreed upon by the federal, provincial and territorial governments, and whether the funding is achieving the expected results. It is important for his government to be able to tell Quebeckers and Canadians whether the health accord, which will expire in 2014, is delivering the promised results. Such an accountability exercise, one to which Canadians are entitled, would be the first step in determining needs and the model that will be negotiated in good faith and in partnership with the provincial and territorial governments, including the Government of Quebec, of course. I therefore invite the hon. member to exert pressure on his government to report back to Canadians on the results of this accord and to begin discussions in order to ensure funding for our health care system and for the objectives negotiated for the well-being of all Canadians.

I would also call on the members opposite to address the underlying causes of the problem. I mentioned earlier that women who are overweight or obese are more likely to have dense breast tissue. Women who smoke and who have low levels of physical activity are also at higher risk of developing breast cancer. The Canadian Institute for Health Information indicated in a report that socio-economic status and poverty are significant social determinants of obesity. The Canadian Council on Learning has confirmed that smoking and low levels of physical activity are related to poverty and a lower socio-economic status.

I therefore invite the hon. member for Barrie and this government to address the employment problems facing Canadians, to implement measures that will help the people of Canada to live in dignity, and to find ways to help families in our ridings so that they do not have to live paycheque to paycheque in order to be able to buy groceries.

Quebeckers and Canadians do not have better jobs than they did two years ago. In addition, young people are once again more affected by unemployment than the Canadian average. Furthermore, the number of children living in poverty is not decreasing, far from it. This government's lack of action in this regard is negatively affecting the health of young people. Action must be taken immediately.

I would like to close by saying that I support the principles of this bill. In order to help all Quebeckers and Canadians, we must find a way to improve access to doctors and reduce wait times for the diagnosis and treatment of various illnesses.

Breast Density Awareness Act
Private Members' Business

11:55 a.m.

NDP

Marie-Claude Morin Saint-Hyacinthe—Bagot, QC

Mr. Speaker, I would like to begin by saying that I fully support a plan for breast cancer screening. I salute the member opposite for his initiative.

We all know that this disease claims the lives of far too many people and that many deaths could be avoided with early detection. We also know that women with dense breast tissue are four to six times more likely to develop cancer, which requires timely screening. Although we approve a complete breast cancer screening program for women with dense breast tissue, this bill is vague and clearly lacks substance. In addition, it will not have any tangible effects. Health care workers and women concerned need more than just encouragement to raise awareness and promote best practices. Once again, the government is failing to provide leadership. When will there be a funding and implementation plan for a real national strategy to improve breast cancer screening?

It is also important that we not neglect other forms of cancer and diseases that could be prevented with screening that is quick, accurate and, above all, accessible to everyone. Under the 2003 and 2004 health accords, the government made the following commitments: reduce wait times and increase the number of doctors, nurses and health professionals.

With this bill, the government is attempting use a band-aid solution to hide the commitments it did not fulfill. Seriously, are we really going to prevent breast cancer by encouraging women to be tested? What about women who do not have access to a family doctor and those who must wait six months for a second test? Everyone realizes that cancer can grow a lot in six months, and I know what I am talking about.

This bill should include the following measures, otherwise it does not serve any purpose, other than being a waste of paper. There must be adequate funding to create systematic breast cancer screening programs. These programs should be free for all women and men, since men can also get breast cancer. Particular attention should be paid to women aged 40 and up. There must also be standards for existing programs to help the provinces that already have a plan. There must be a plan for the particular issue related to screening for women with dense breast tissue. We must also work with Nunavut to help the territory implement its first screening plan. We absolutely must ensure that the entire Canadian population has access to a family doctor and to specialists within a reasonable period of time. We must also give general practitioners, gynecologists and oncologists the tools they need and the necessary equipment to conduct tests within a reasonable period of time.

I remind members that more than 5 million Canadians do not have access to a family doctor. That is what we should be addressing. We know that the earlier a cancer is detected, the more effective treatment will be. This applies to all forms of cancer. This government often neglects research, development and innovation. A lot of studies are currently underway but are underfunded. I do not think it is hard to understand: if we invest strategically in research, we can solve a number of problems at every level.

We must also make considerable investments in psychological care for people who are diagnosed with cancer and their families. Cancer affects most families in Canada, directly or indirectly. Even if we implement prevention programs, we also need assistance programs for people who are living with cancer.

Breast cancer is the most common form of cancer in Canada. It is crucial that patients and their families receive support as they fight this terrible disease. We need to do more than simply create awareness and encourage screening. Organizations that fight against breast cancer agree that this bill does not bring significant improvements to screening measures for the women who are most at risk of developing breast cancer. They know what they are talking about. The Conservatives seem to think that this is another area of health care where the federal government has no role to play.

I will say it again—the government needs to take a lead role in health care issues and it needs to work with the provinces. In fact, what we need are large-scale improvements in existing screening programs. Of course, that includes better funding, as I have said before, along with clear standards and the establishment of screening programs in all regions of the country.

The NDP has long been calling on the government to play a fuller role in primary health care and preventive care. Obviously, breast cancer screening measures should be part of that.

A number of groups share our opinion. And I think that the government should listen to them from way up there in its ivory tower because they are the ones on the ground who know the issue.

Quebec's association of hematologists and oncologists says that while it is important to increase breast cancer screening, we cannot forget about other kinds of tumours. Improvements need to be made in the prevention of and screening for all cancers. We must not concentrate all our efforts on one group of women or one type of cancer.

The MQRP and Canadian Doctors for Medicare are saying that we have to ensure that patients have timely access to general practitioners and specialists in order to undergo the necessary tests to get a timely diagnosis. As I was saying earlier, cancer spreads quickly. Access to the health care system, according to the MQRP, to me and to the NDP, is the key solution in battling breast cancer and significantly increases patients' chances of survival.

Dr. Maté Poljicak, a surgical oncologist and director of an interdisciplinary team of breast cancer specialists at the Centre hospitalier universitaire at the Université de Montréal, says that in some cases, such as those for women with dense breast tissue, mammography is not an effective breast cancer screening method. MRIs and much more advanced imaging screens are needed in those cases.

The Canadian Breast Cancer Network, which is run by cancer survivors, does not believe this bill could improve screening procedures for women at greater risk of developing breast cancer.

This network is calling for—

Breast Density Awareness Act
Private Members' Business

12:05 p.m.

Conservative

The Acting Speaker Barry Devolin

I am sorry to interrupt, but 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.

The hon. member for Saint-Hyacinthe—Bagot has three minutes left for the next time.

The House resumed from October 20 consideration of the motion that Bill C-18, An Act to reorganize the Canadian Wheat Board and to make consequential and related amendments to certain Acts, be read the second time and referred to a committee, of the amendment and of the amendment to the amendment.

Marketing Freedom for Grain Farmers Act
Government Orders

12:05 p.m.

Conservative

Merv Tweed Brandon—Souris, MB

Mr. Speaker, Canadian farmers feed the world and they deserve the freedom to make their own business decisions, whether it is to market individually or through a voluntary pooling entity. We believe that all Canadian farmers should be able to position their businesses to capture the marketing opportunities that are open to them.

This bill aims to give western Canadian farmers the right to choose how to market their wheat, durum and barley independently or through a voluntary pool. The marketing freedom for grain farmers act proposes to end the Canadian Wheat Board's six-decade-old monopoly over sales of wheat, durum and barley in western Canada. It will give wheat and barley growers across western Canada the same rights that canola and pulse growers enjoy along with farmers in other parts of Canada, namely, the right to do what they want with the crop they paid to plant, grow and harvest. By allowing market freedom, grain growers will be able to market based on what is best for their needs and businesses.

I want to talk a bit about what the opportunity means for Manitobans, where wheat and barley are major drivers of the provincial economy, generating almost $800 million in farm cash receipts and over $900 million in exports just last year. Monopoly is a model no longer appropriate in a modern growth-oriented commodity sector in Canada. Milton Boyd, a professor and economist at the University of Manitoba, agrees. He has stated:

—all of the major grain marketing boards around the world have already disappeared (or have been privatized) over the last 20 years...mainly because farmers and consumers worldwide have wanted economic reforms, competition, and freedom to choose.

Under marketing freedom, we can look forward to increased innovation and new value-added industries. The removal of the monopoly would allow Manitoba farmers to sell their grains directly to a processor, whether it be a pasta manufacturer, a flour mill or any other of their choosing. Farmer entrepreneurs would have the option of staring up their own small specialty flour mills and pasta plants, without the red tape it currently involves.

There has been tremendous growth in value-added opportunities for oats, pulses and canola across the Prairies over the past 20 years. There is no reason not to expect more opportunities for wheat, durum and barley.

In Manitoba alone the acreage of oats has increased by over 250,000 acres since it was removed from Wheat Board control. This has allowed for the opening and expansion, as an example, of Can-Oat Milling, a processing mill in Portage la Prairie. Just over the border in North Dakota from where I live, many new pasta plants have sprung up and created jobs that very well could have been created in Manitoba.

Recently we heard great news coming out of we Regina that a pasta plant was turning the sod to take Canadian durum next year. That is how quick it can happen. These are the types of value-added industries and jobs that exist when farmers have the option to market their products as they choose. This, along with increased trade, could create many new jobs and opportunities. We know this is a significant change involving a very complex set of issues.

The bill proposes to give farmers and the industry a transition period of up to five years to allow time to adjust to the significant and positive change to their businesses and business models. To avoid market disruption, the goal is for farmers and grain marketers to start forward contracting for the 2012-13 crop year as soon as it is possible. During the transition period, the interim Canadian Wheat Board will continue to offer farmers the option of pooling their crops with initial prices guaranteed by the Government of Canada. During this time, the interim CWB will develop a business plan for full privatization.

Our government is ready to work with the Canadian Wheat Board to chart the way forward because we believe that an open and competitive grain market can and should include a viable voluntary Canadian Wheat Board.

Because innovation is critical to the future of the Canadian grain industry, the proposed bill also provides for a voluntary funding mechanism to support research and market development. We fully recognize that there will be costs associated with this transition and the voluntary Canadian Wheat Board will be a smaller organization than the one existing today. Our government is prepared to assist with the extra ordinary costs associated with winding down this monopoly.

Farmers currently pay the daily costs of operating of the CWB with the overall costs guaranteed by our government. With this change, the government recognizes that farmers should not be left alone to deal with the costs of transition to a voluntary mandate and therefore our government is ready to assist, while making responsible use of taxpayer dollars.

Another important facet of the bill deals with the Port of Churchill, which in the past has relied heavily on Canadian Wheat Board shipments. Our government recognizes, and has demonstrated, our support and commitment to the north. We understand the importance of the Port of Churchill as a valuable asset and we are working with stakeholders across the agricultural industry, as well as other industries, to explore development opportunities for the port and we are looking at a number of initiatives to continue to diversify the economy of Churchill.

Jim Carr, the president and CEO of the Business Council of Manitoba said, “We see Churchill as more than a port that takes Wheat Board grain. We see Churchill as the Arctic Gateway”. The managing director of OmniTRAX, Mike Ogborn, said that his organization “sees a strong future for the port and the railway”. Our government agrees with these comments. The Port of Churchill will remain the Prairies' Arctic gateway to the world.

With regard to the concerns around short lines, which have been raised by many members of the opposition, the Government of Canada, not the CWB, protects the right of producers to use short line railways and inland terminals and we will continue to ensure these producers have that access.

Grain growers in Manitoba are like any other business people. They want to make the right decisions at the right time for their farms and their families. They already decide what to plant and when to harvest. They make marketing decisions on their canola and pulse crops, their peas, lentils, beans, oats and many other crops. They just want the same marketing freedom for their wheat, durum and barley.

Spencer Fernando of The Manitoban said:

The end of the Canadian Wheat Board monopoly restores the rights of western farmers, and shows we respect the freedom of individuals to control their own labour and the products of that labour. It is the right thing to do, not just economically, but also because it lives up to the principles upon which Canada is based.

My government trusts farmers to make their marketing choices, based on what is best for their businesses, families and communities. We want to put farmers back in the driver's seat so they can continue to drive this economy. We believe that an open and competitive grain market can include a viable voluntary pooling entity and we are ready to work with the Canadian Wheat Board to chart that future.

We owe it to farmers, customers and shippers to provide market certainty so they can plan their businesses for the following year. With this change, our entrepreneurial farmers can expand markets, increase their incomes and attract greater investment now. So why make them wait? Marketing freedom has been a cornerstone of our platform since day one and it was part of our throne speech last spring. I am proud that we are delivering on our long-standing promise to the western grain farmers. As the Prime Minister has said, what we are seeing here is a new horizon, a new field of opportunity, not just for western grain farmers but for workers and businesses in western Canada generally.

An open grain market will attract new investment, encourage innovation and create new jobs for Canadians. I support that.