House of Commons Hansard #94 of the 41st Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was health.

Topics

Drug Shortages
Emergency Debate
Government Orders

7:10 p.m.

Liberal

Hedy Fry Vancouver Centre, BC

Mr. Speaker, actually, I am getting quite confused about what the provincial and federal jurisdictions are. I thought I knew what they were because I used to be a government minister. I thought I understood that very well when I went to federal-provincial-territorial meetings.

On the one hand I hear the provinces say that the federal government had a duty to warn them earlier. Obviously the provinces think that the federal government should be the one that warned them. Then the minister said that if she had known sooner, she would have warned the provinces sooner.

We are getting mixed messages. It is obvious that the minister believes it was her duty to inform the provinces about the problem, that it is her duty to find substitute drugs, and it is her duty to do a lot of things.

How can the minister believe she has the duty and then say it is a provincial jurisdiction in the next breath?

Drug Shortages
Emergency Debate
Government Orders

7:10 p.m.

Conservative

Wladyslaw Lizon Mississauga East—Cooksville, ON

Mr. Speaker, the member opposite mentioned that she has been around for a long time and was on the government side. I am surprised she is actually asking the question because the regulations are the same as they were when she was in government. Nothing has changed in that respect.

It is the responsibility of the federal government to regulate the safety of drugs. The hon. member knows very well that all the contracts and purchases are done by the provincial bodies under provincial jurisdiction.

To answer the question, the minister showed great leadership to help in the situation in any way she could. That is great leadership.

Drug Shortages
Emergency Debate
Government Orders

7:10 p.m.

Conservative

Joy Smith Kildonan—St. Paul, MB

Mr. Speaker, the member's commentary on this very important issue was very insightful.

I would like the member to inform the House where Canadians can find the most up-to-date information on the Sandoz shortage. I know there is a place where that can be found.

Drug Shortages
Emergency Debate
Government Orders

7:15 p.m.

Conservative

Wladyslaw Lizon Mississauga East—Cooksville, ON

Mr. Speaker, Sandoz is providing regular updates on the supply situation to its provincial and territorial customers.

For information on actual or potential local impacts, we encourage Canadians to contact their local health care authorities and their health care professionals.

Sandoz is committed to posting the information for health professionals on current and potential drug shortages on its website, and on the website of the University of Saskatchewan, Saskatchewan Drug Information Services, and Ruptures d'approvisionnement en médicaments au Canada. This information can be accessed.

Drug Shortages
Emergency Debate
Government Orders

7:15 p.m.

Lotbinière—Chutes-de-la-Chaudière
Québec

Conservative

Jacques Gourde Parliamentary Secretary to the Minister of Public Works and Government Services

Mr. Speaker, we are here this evening to discuss drug shortages. We have to understand and talk about the fact that the pharmaceutical industry supplies drugs and decides which drugs and how much of them to produce.

The pharmaceutical industry is in the best position to monitor actual and potential drug shortages and to share that information with stakeholders.

We would not be here tonight if the industry had done that. The industry is responsible for the nationwide drug shortages. Our government is very disappointed that Sandoz failed to fulfill its commitment to provide timely, accurate information about actual or potential drug shortages.

We believe that Sandoz could have prevented the shortage by issuing a press release about changes to its drug production volumes. Sandoz's failure to communicate made it even harder for patients and our health system to deal with a difficult situation. Our government is responsible and must ensure that there is no threat to the health of 34 million Canadians or the system they rely on.

Our current system is facing many complex, closely related challenges that create the conditions conducive to drug shortages. Production delays or the discontinuation of products are the factors contributing to shortages that are most commonly cited by Canadian sources. This problem is certainly not unique to Canada. This is a universal phenomenon that results from the ever-increasing globalization of the supply chain.

Despite these global challenges, we would be remiss if we did not draw attention to the shortcomings of Sandoz at the local level that contributed to the drug shortages we are currently experiencing. When Sandoz decided to stop production in response to concerns raised in a letter from the Food and Drug Administration in the United States, a letter that indicated that Sandoz was not following good manufacturing practices, did it consider the consequences this decision would have for the Canadians who need its products?

According to responsible business practices, a company with an international clientele, like Sandoz, must think about its responsibilities to all the patients who use its products, whether American or Canadian.

When a manufacturer makes decisions regarding the production of drugs used in hospitals to treat serious diseases, does it ensure that its clients, hospitals, have an adequate stockpile of drugs before stopping production?

Based on what happened at Sandoz, the only answer to this question is no. One of the disadvantages of the fact that the industry is always trying to improve efficiency is the risk of disruption. And when this disruption happens, there is a good chance that the supply chain will suffer.

How many of these companies get their raw materials from a single source or a limited number of sources? By limiting the number of their suppliers, manufacturers are exposed more to supply interruptions. When they can, companies should have more than one supplier of their basic ingredients.

This principle also applies to drug purchasers, including hospitals and drug benefit plans. That is why the government asked Sandoz to look in Canada and abroad for other suppliers or other facilities that could quickly produce the most essential drugs in order to minimize the impact this would have on patients in Canada.

Have Canadian manufacturers put in place appropriate contingency plans in the event of a disruption in supply? Again, the Sandoz case would suggest not. If Sandoz had had risk mitigation strategies, the current situation could have been avoided.

Unfortunately, doctors and pharmacists are now in a delicate situation. They have to make substitutions using only the stock they have on hand. If the manufacturer had warned them early enough, they would have been better prepared and could have made other arrangements.

These companies know how much their products are needed. Although they do not see every patient who benefits from their products, they should not forget that the victims of their lack of transparency and lack of honest communication are the patients.

Sandoz failed to follow a best practice we expect from a global company. As it was focusing exclusively on upgrading its equipment and on opening up the U.S. market for its product, it ignored the effects this would have on Canada. The consequences are unacceptable.

Sometimes unethical business practices are used after a manufacturer issues a notice of a drug shortage.

For example, some wholesalers might procure drug reserves at a reduced price in anticipation of a possible change in price by a manufacturer in order to maintain their profit margins. Rumours of price increases could also cause pharmacists to build up reserves.

One would hope that all parties put the patients' needs above profits, because health and safety must come first.

The Government of Canada encourages its industry partners to be more transparent when it comes to their manufacturing processes and to be more communicative about them.

We are also working with our provincial and territorial partners to increase the number of drug production sources because when we rely on sole sources we are more vulnerable to shortages.

In that regard, the Minister of Health has told the provinces and territories a number of times to enhance the efficiency of their system.

Even though negotiating contracts with a sole drug supplier can indeed result in cost savings in the short term, those savings must not open the door to risk or higher costs in the long term.

For that reason the federal government strongly encourages provincial and territorial health authorities to obtain drugs from several suppliers in order to avoid being vulnerable to interruptions in the production of a single supplier.

All health professionals working in the system and their associations are already doing everything in their power to ensure that patients get the treatment they need. However, the lack of coordination of time-sensitive communications increases the burden on the system.

In the end, Canadians will pay for this weakness in the system: they will either have to pay more for expensive substitutes, or their health will be compromised because of delayed treatment.

That is why greater transparency is needed throughout the supply chain and there must be better communication on the part of industry. The industry must honour its commitments with respect to clear, transparent and timely communication of all information on current and potential drug shortages.

The federal government has thus insisted that Sandoz use public websites for reporting drug shortages to provide that information so that health professionals have access to the information they want.

Drug Shortages
Emergency Debate
Government Orders

7:25 p.m.

NDP

Denis Blanchette Louis-Hébert, QC

Mr. Speaker, I thank the member for Lotbinière—Chutes-de-la-Chaudière for his speech, in which he listed many aspects of the problem. The only problem I can see is his conclusion. He states that the pharmaceutical industry should be somewhat more co-operative. As it is not, because profit comes first, we are experiencing shortages.

I have a question for my colleague. In view of the fact that pharmaceutical companies will not want to voluntarily discuss their problems—and these are definitely their problems—and they will also not want other companies to know they are having problems, when should reporting no longer be voluntary and measures be imposed to ensure that the patient comes before profit, as my colleague said?

Drug Shortages
Emergency Debate
Government Orders

7:25 p.m.

Conservative

Jacques Gourde Lotbinière—Chutes-de-la-Chaudière, QC

Mr. Speaker, I thank my colleague for the question. Our government is determined to implement a system that works for Canadians. In the future, we will ensure that the national drug shortages monitoring and reporting system has the most accurate and up-to-date information so that decision-makers, health administrators, health care professionals and patients have the information they need.

As already mentioned, work is under way to create a single website to report drug shortages. The problems we experienced recently in terms of drug supply interruptions following the fire at the Sandoz plant in Boucherville, Quebec, are proof that this work needs to be completed immediately.

We must learn our lessons from this shortage. Let us ensure that every link in the drug supply chain takes the necessary precautions, as we have done at the federal level. It is only by admitting that some things need to change and by acting on them that we will create an improved health care system that is more efficient and more resilient for all Canadians.

Drug Shortages
Emergency Debate
Government Orders

7:25 p.m.

Conservative

Joy Smith Kildonan—St. Paul, MB

Mr. Speaker, I thank my colleague for his very insightful speech and some wonderful suggestions.

Could the member please explain what system is in place right now to encourage companies to report drug shortages? Also, can the government force companies to share information about drug shortages?

Drug Shortages
Emergency Debate
Government Orders

7:25 p.m.

Conservative

Jacques Gourde Lotbinière—Chutes-de-la-Chaudière, QC

Mr. Speaker, I would like to thank the hon. member and all the other members on this side of the House for their excellent questions.

The industry, whether it be the manufacturers, wholesalers or distributors, is in the best position to detect and monitor potential drug shortages. That is why the Minister of Health has clearly communicated her expectations to industry partners. Industry partners must agree on practices that will allow them to give doctors advance warning of potential drug shortages so that they can adapt accordingly. If the industry partners cannot or will not do that, we are prepared to act in the best interest of patients and prescribe a solution.

Our government is emphasizing that communication must be improved and it is expecting industry partners to provide accurate and relevant information about current and potential drug shortages and to keep their commitment to making accurate, complete and relevant information about current and potential drug shortages available to health professionals and patients across Canada.

In closing, the federal government is closely monitoring the relevance and comprehensiveness of the information being provided by Sandoz in order to ensure that the company is meeting the needs of its clients and health professionals.

Drug Shortages
Emergency Debate
Government Orders

7:30 p.m.

NDP

Robert Chisholm Dartmouth—Cole Harbour, NS

Mr. Speaker, I will be sharing my time with the member for Manicouagan.

I am pleased to speak in this important debate tonight. I thank my colleague, the member for Vancouver East, for introducing the motion.

Why are we here tonight? We are here as a result of a very serious situation that has resulted from a large manufacturer and supplier of drugs in this country that has come up short and is unable to meet the demand for drugs. There is no question that this is a crisis situation but it is not new. It has been ongoing for at least five years and the government has been well aware of that.

In fact, the Minister of Health finally responded to pressure from organizations in the health care sector, the provinces and the opposition in August 2011 and began working with the industry and associations across the country to come up with a solution. What solution did she come up with? She came up with a voluntary monitoring system whereby companies, like Sandoz, were supposed to voluntarily indicate what their status was in terms of its ability to supply drugs to health authorities and hospitals across the country.

We need to ask how that is working so far. The problem is that it is not working. We are not just talking about there being a bit of a delay here. We are talking about this affecting tens of thousands or hundreds of thousands of Canadians who are receiving or are about to receive elective surgery and will not get the kind of injectable drugs they need. We are talking about people receiving cancer treatments or treatment for epilepsy, and transgenders who are receiving treatment and injecting various drugs in order to ensure their progress is insured. Those are the people being affected as a result of this decision.

Who is Sandoz and what does it do? Sandoz supplies 90% of injectable drugs to hospitals from one end of the country to the other. It is no little corner store type drugstore. It is a significant company that is providing medicines, drugs and pharmaceuticals to provinces from one end of the country to the other. The government says that it cannot step in and use too strong a position with respect to the company because it is a provincial jurisdiction and it would be stepping on its toes.

The government already has an important role to play with respect to drugs in terms of registering, reviewing, monitoring and ensuring they are safe, although it is having some trouble with its ability to do that. However, it has been asked by many provinces and Canadian associations that represent anesthetists and pharmacists, as well as the Canadian Cancer Society to step forward and deal with the problem by putting some teeth into its ability to monitor the supply of drugs to the provinces and hospitals across the country.

The United States is doing that. Last year, the President of the United States recognized that there was a serious problem with drug shortages in the U.S. The pharmaceutical companies were unable to meet the demand for drugs and were not letting health authorities and hospitals know the situation and what their ability was in terms of meeting the demand or what the supply would be.

The government has said the companies will tell us whether they are able to supply the drugs, what drugs they will be able to supply, and they will voluntarily declare when they are having some trouble. In this case, Sandoz was advised in November of 2011 by the FDA in the U.S. that there were real problems with some of their facilities and that their production was going to be interrupted if it did not bring some of them up to standard. One of them was the plant that had production interrupted in Quebec.

Did the government hear about that? There was not a word. Did Canadians hear about that? There was not a peep. It was not until late February of this year that we began to get an indication that, in fact, there was going to be an interruption to the supply of drugs to hospitals and jurisdictions across this country. Clearly, the government's own strategy of asking the pharmaceutical companies to voluntarily, pretty please, make that information available has not worked. What this resolution says and what my colleagues on this side have said, one after the other in an incredibly articulate fashion, is that the government has to step forward and take some responsibility. It has to recognize that the strategy it put in place is not working and that Canadians' safety and health are at risk as a result of its failure to act.

The point is simply this. It should work with the provinces and health jurisdictions across the country and come up with one national system to monitor the supply of drugs across the country. It is that simple. It is not complicated. We are not talking about it coming in with a heavy hand, as it is doing in the Air Canada dispute, and taking the side of the employer and putting the jackboot down on working people. We are not asking it to move with that type of aggressive action. We are asking it to recognize that it is a partner in health care. The federal government and the provinces have a joint constitutional responsibility to ensure Canadians receive a certain quality of health care in this country. The government continually wants to abdicate that responsibility, and that is a problem for New Democrats.

In this debate, we are simply pointing out the flaws to the voluntary system. “Pretty please, big Sandoz, tell us what is going on and we will be okay” is not working. The government has to start putting some teeth to these issues and begin to deal with this question once and for all. It is not going to work otherwise, and that is the issue. If we do not deal with it, Canadians' health, comfort and ability to receive the treatment they need when they need it is jeopardized. Surely the government recognizes that is a situation that needs to be avoided.

Members on this side are telling the government to work with the provinces, recognize their jurisdiction and its own jurisdiction, take some responsibility and action to ensure this kind of situation does not happen again and the Canadians, because of their health circumstances, who need safe pharmaceuticals will receive them when they need them without going through these kinds of delays.

I am thankful we were able to proceed with this important emergency debate at this particular point in time.

Drug Shortages
Emergency Debate
Government Orders

7:40 p.m.

Liberal

Hedy Fry Vancouver Centre, BC

Mr. Speaker, let us for a moment accept the federal government's statement that it is not responsible for the well-being and health of Canadians across this country. Does the member think that at the very least the federal government should be responsible for the health and well-being of the people for whom it has direct responsibility, such as first nations, Inuit, RCMP, the armed forces and veterans? And taking that responsibility seriously, does the member believe that the federal government should therefore set up a system similar to the one in the FDA in the United States where it anticipates and works with manufacturing companies to address, prevent and avert shortages before they occur?

Drug Shortages
Emergency Debate
Government Orders

7:40 p.m.

NDP

Robert Chisholm Dartmouth—Cole Harbour, NS

Mr. Speaker, there is no question that constitutionally the federal government has direct responsibility for certain identified groups. However, we have increasingly seen that it has been devolving the responsibility by shoving those folks, whether they be veterans or others, onto the responsibility of the province. I do not accept that the federal government does not have some responsibility, and I want to say to the government that if it is not prepared to step up and take its responsibilities seriously, to clear those benches and let us elect the government that will take its responsibilities seriously.

Drug Shortages
Emergency Debate
Government Orders

7:40 p.m.

Simcoe—Grey
Ontario

Conservative

Kellie Leitch Parliamentary Secretary to the Minister of Human Resources and Skills Development and to the Minister of Labour

Mr. Speaker, I want to make a comment regarding what the hon. member for Vancouver Centre said earlier, that she was somewhat confused about where provincial and territorial decisions are being made. It also seems that the NDP is slightly confused. I am happy to provide some direction on this.

There is leadership being shown and it is on the issue of supply. Although the provincial and territorial areas are responsible for determining drug supply and for determining what suppliers will be used in their jurisdiction, we are in a circumstance where we are working with industry and we will help identify and fast-track. That is our responsibility. However, it is the responsibility of the provinces and territories to work with suppliers to ensure that those patients who they know well in their jurisdictions are receiving the medications they need. We encourage them to do so. I would like the member opposite's comments on that.

Drug Shortages
Emergency Debate
Government Orders

7:40 p.m.

NDP

Robert Chisholm Dartmouth—Cole Harbour, NS

Mr. Speaker, the only people who are confused on this issue are those on the government side, on this and many other issues. When it comes to standing up and fighting on behalf of Canadians, when it comes to solving problems that are facing Canadians, hundreds of thousands of Canadians today are having their health care affected as a result of this decision and as a result of a lack of action. What members on this side are saying and what I have said is that the government has to step up, take some responsibility, work with its partners, work with the provinces, work with the hospitals, work with the health care associations across this country and get this problem solved once and for all. That is not that difficult to understand.

Drug Shortages
Emergency Debate
Government Orders

7:45 p.m.

NDP

Djaouida Sellah Saint-Bruno—Saint-Hubert, QC

Mr. Speaker, I want to thank the hon. member for his very interesting speech.

The thing that concerns me the most is the health and safety of our fellow Canadians. Under Canadian law, we know that the government has to ensure health and safety, but even more importantly, ensure access to care and therefore access to drugs. The current shortage is the worst we have seen.

Why has the Conservative government not shown any leadership and been proactive, despite the warnings it received from a number of organizations?