House of Commons Hansard #96 of the 41st Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was drugs.

Topics

Questions Passed as Orders for Returns
Routine Proceedings

3:30 p.m.

Some hon. members

Agreed.

Motions for Papers
Routine Proceedings

March 14th, 2012 / 3:30 p.m.

Regina—Lumsden—Lake Centre
Saskatchewan

Conservative

Tom Lukiwski Parliamentary Secretary to the Leader of the Government in the House of Commons

Mr. Speaker, I ask that all notices of motions for the production of papers be allowed to stand.

Motions for Papers
Routine Proceedings

3:30 p.m.

Conservative

The Speaker Andrew Scheer

Is that agreed?

Motions for Papers
Routine Proceedings

3:30 p.m.

Some hon. members

Agreed.

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:30 p.m.

NDP

Libby Davies Vancouver East, BC

moved:

That, in the opinion of this House, the government should: (a) in cooperation with provinces, territories and industry, develop a nationwide strategy to anticipate, identify, and manage shortages of essential medications; (b) require drug manufacturers to report promptly to Health Canada any planned disruption or discontinuation in production; and (c) expedite the review of regulatory submissions in order to make safe and effective medications available to the Canadian public.

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:30 p.m.

Conservative

The Speaker Andrew Scheer

Since today is the final allotted day for the supply period ending March 26, 2012, the House will go through the usual procedures to consider and dispose of the supply bills. In view of recent practices, do hon. members agree that the bills be distributed now?

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:30 p.m.

Some hon. members

Agreed.

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:30 p.m.

NDP

Libby Davies Vancouver East, BC

Mr. Speaker, I am very pleased to rise in the House today to begin the debate on the NDP motion dealing with the current very difficult situation with drug shortages. I will be sharing my time with the member for Beauharnois—Salaberry.

As members know, this motion follows an emergency debate on Monday. I would like to thank the Speaker for allowing that debate to take place. It was a very important opportunity for members of the House to express their concerns and perspectives on the issue of the current crisis of drug shortages and, more important, to put forward suggestions and ideas about what we should do to deal with that shortage. The fact that we had the debate on Monday was a very good first step.

I am very pleased today that the NDP is presenting the motion, which will be voted on later. We are very much hoping that all members in the House from all sides will come together. As the Leader of the Opposition said today in question period, we must work together to protect patients in our country. That is certainly the intent and the belief contained within the motion.

The motion states:

That, in the opinion of this House, the government should: (a) in cooperation with provinces, territories and industry, develop a nationwide strategy to anticipate, identify, and manage shortages of essential medications; (b) require drug manufacturers to report promptly to Health Canada any planned disruption or discontinuation in production; and (c) expedite the review of regulatory submissions in order to make safe and effective medications available to the Canadian public.

We have had an enormous amount of information in the media. I also know we have all been receiving emails and phone calls about the impact of what the drug shortage is doing in Canada. We know that the crisis we face today specifically was triggered by the shutdown of the Sandoz drug production facility in Quebec.

What really concerns us, and the reason we wanted to bring this forward, is we believe this production shutdown and this crisis could have been prevented. If there had been an adequate plan in place by the federal government, we would not be here today debating the motion. Nor would we have had the emergency debate on Monday.

We know that Sandoz supplies 90% of all the injectable medications in Canada, and 100% of the narcotic painkillers and sedatives. This is obviously a very important facility and its shutdown had a very immediate impact.

I want to spend a few minutes talking about that impact. We know that the shortage is having the most serious impact on patients who are in intensive care units and those who are dying and are in need of pain management. We can only begin to imagine the stress and anxiety that places on patients who are in very difficult circumstances, but also on their families and loved ones. This is something that is very compelling.

We also know that injectable opioids are the main method for pain control for surgery, post-operative care and for any hospital admission. With the hospitals running low on these drugs, they are now being forced to cancel elective surgeries in order to save these medications for severely ill patients. We can see the domino effect that is beginning to take place in hospitals across the country.

We have also heard from nurses who work in palliative care. These people are on the front line. They have noted that for many people in palliative care, they are dependent on injectable opioids since they cannot take medications orally.

One of the things I was just horrified to hear was the reports from the Canadian Pain Society. It has told us that it has seen an increase in people who are putting out calls for help because they feel suicidal. They are very concerned that they will be unable to manage their chronic pain without the necessary medications.

We have also heard that people dealing with epilepsy are facing shortages and are very concerned about whether they will be able to have access to drugs. As well, individuals going through transgender surgery are also facing very difficult circumstances.

Although this immediate crisis was triggered by the shutdown of the Sandoz plant, I want to make it very clear that this, unfortunately, is not a new situation. As far back as September 2010, there were many reports across the country about drug shortages. In fact, the Canadian Pharmacists Association did a survey of its members and astoundingly 93.7% indicated they had trouble locating medications to fill a prescription in a week and 89% of the pharmacists surveyed indicated that drug shortages had greatly increased in the previous year. Already we were seeing a very difficult situation.

It seems pretty incredible that people can go to a pharmacy thinking they will get their prescription refilled only to find out the drug is not available and everyone is put into a scramble. Just imagine the time and resources that takes.

I want to make the point that although we have had a particular situation right now with Sandoz, this has been a more structural and systemic problem in Canada, and indeed globally. Unfortunately, it has been a problem, and now a crisis, to which the federal government has not responded.

We know the federal government set up a working group in 2010. It has eight organizations in it, largely made up of industry. There is no patient representative organization on the group. However, the big problem is it was to come up with suggestions for a voluntary system. As we know, that has been completely ineffective. If it were effective, we would not have had an emergency debate on Monday and we would not have this debate today.

I know there are different perspectives, and I will get into the jurisdiction question, but the fact is the measures that the federal government put in place have simply not worked. They have failed and we have pointed that out repeatedly every day in question period and in the debates that we have had.

What happened was the provincial jurisdictions, in the absence of effective federal leadership, took it upon themselves to try to solve the problem. I applaud them for that, but they are left scrambling to try to figure out what to do. We know that health ministers from B.C., Alberta, Saskatchewan, Manitoba, Ontario and Quebec have been working together, through calls, working groups and so on, to determine how they can share the current supply and obtain a new sustainable supply. The health minister from Alberta, Mr. Fred Horne, put it best when he said, “We're not going to stand by and simply wait to hear from Sandoz or the federal government”. They could not. They had to jump in and do something in the absence of any plan or action.

We need to reflect and acknowledge that the responses the federal government gave, particularly from the Minister of Health, have been absolutely inadequate and have fallen far short of what needs to be done.

Umpteen times now in the House, in question period and in committee, I have heard the Minister of Health deal with the jurisdiction question. It seemed like the Conservatives were blaming everyone else for the problem, rather than looking at what they could proactively do.

I do not believe this debate is about jurisdiction. It is not about the federal government delivering health care services or treading on provincial jurisdiction. It is about the federal government's responsibility, under the Canada Health Act, to deal with this crisis. Therefore, let us get off the jurisdiction thing and figure out what we will actually do about it.

We have put forward some very concrete proposals in our motion that we believe will deal with both the short-term immediate crisis as well as long term. We want to see a nationwide strategy, in co-operation with provinces and territories and industry. We want to have reporting required. This is a key point. The voluntary reporting has not worked, so many people are now calling for mandatory reporting. That is very important.

In closing, I appeal to all members and all parties in the House to work together on this issue. I am very hopeful that this motion will pass. We will be voting on it tonight, so it is very immediate. We can show the goodwill of the House to deal with this problem in a non-partisan way and also that we can take action at the federal level, working with our provincial and territorial counterparts and with industry as well both on the short-term immediate crisis and on a plan for the longer term. If we have that commitment, we will restore some credibility and faith with the Canadian public that we can deal with this crisis.

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:45 p.m.

Oshawa
Ontario

Conservative

Colin Carrie Parliamentary Secretary to the Minister of Health

Mr. Speaker, I listened to the speech by my colleague who sits on the health committee. One of the biggest problems we are having here is misinformation. The member for Vancouver East said that elective surgeries were being cancelled in Vancouver. This is based on an inaccurate story in the media. Hospital officials corrected the record and confirmed that the surgeries are happening today.

My concern is that members are blowing things up without checking the facts. Why does the member not check her facts?

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:45 p.m.

NDP

Libby Davies Vancouver East, BC

Mr. Speaker, we do our utmost to ensure that all the information we are presenting is accurate. Certainly the media is one source of information, but it is not the only source. We have had many emails from people in the field, front-line health care workers, including from Vancouver. Obviously this is something I want to pay attention to because it is my hometown.

I am puzzled by the member's question. It does not deal with the substance. Is he saying there is not a problem? If he is saying that, come on. The fact is that all of the information tells us that we have a really serious problem. I would much prefer if the parliamentary secretary would tell us what he and his government are going to do to deal with the current situation rather than focusing on one small point. Let us get to the substance of this and get some remedies.

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:45 p.m.

NDP

Robert Chisholm Dartmouth—Cole Harbour, NS

Mr. Speaker, I have a few facts in which the member opposite may be interested. We had the emergency debate on Monday and we talked about this issue. One of my constituents, a veterinary physician at an emergency animal hospital in my riding, sent me a note to say that it not only affects humans, but it also affects animals. Veterinarians are having problems. They have to come up with new protocols. They are trying to figure out how to treat the animals in their care because they are the last ones to get the medications after humans. It is putting a great deal of stress and pressure on their practices and their ability to serve their clients.

Does the member share my concern that there are more Canadians who are being affected by this problem than the government is prepared to admit?

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:45 p.m.

NDP

Libby Davies Vancouver East, BC

Mr. Speaker, something I was not aware of was how the shortages affect veterinarians and their treatment of animals and people's pets. We can see how this situation is widening and it is only going to deepen unless we come to grips with the situation internationally and certainly here in Canada.

I am very concerned that the U.S. has taken much stronger action. In Monday's debate I read into the record some of the information about President Obama's response to this crisis and the fact that Congress is taking very strong action.

Clearly, the federal government has an enormous amount of power to deal with this situation which affects humans first and foremost, but which spreads throughout our society.

I thank the member for bringing forward this information. It tells us just how wide this crisis is.

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:45 p.m.

Liberal

Ted Hsu Kingston and the Islands, ON

Mr. Speaker, I thank my hon. colleague for talking about the effects on Canadians of the shutdown at Sandoz. This problem has been going on for almost two years now. Another aspect of this problem is that it affects generic drugs more than brand name drugs.

In that case, it does not get noticed by certain groups of people, for example, people who are covered by drug plans. This happened to my father. He was taking a generic drug and then had his prescription changed. He asked why his prescription had changed. There is a creeping change. People on drug plans do not notice because the costs are taken care of by the drug plan, but there could be costs that are increasing which we do not know about. Would my hon. colleague agree that some study is needed to look at how this is affecting the overall cost of our health care system?

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:50 p.m.

NDP

Libby Davies Vancouver East, BC

Mr. Speaker, the member made an important comment. Further examination is required as to what has taken place within the industry. Suggestions have been made that some of the shortages have to do with the fact that companies are downplaying the cheaper generics or putting them out of production in favour of much more expensive newer drugs under the generic cover. This could be exacerbated through the comprehensive economic and trade agreement, CETA, that is being negotiated with the European Union. There are many concerns that it would raise the cost of generic drugs. It is a complex issue and it does require examination.

Let us deal with the crisis right now. Let us also examine how to get control over what is happening in this very powerful market to make sure that the needs of Canadians for pain medications and medications in general come first.

Opposition Motion—Drug Shortages
Business of Supply
Government Orders

3:50 p.m.

NDP

Anne Minh-Thu Quach Beauharnois—Salaberry, QC

Mr. Speaker, I thank my colleague from Vancouver East for her very pointed speech. She has a great deal of compassion, and she quickly realizes what needs to be done and what action the government should take to effectively ensure Canadians' health and safety.

I am very proud to speak today about the proposals in the opposition motion to find a permanent solution for and to resolve the current drug shortage, which has also occurred on a number of occasions in the past. Canadians, health experts and patients are asking the federal government to take action to ensure the safety of the health system. A federal plan is needed and is long overdue. At present, there is no plan, hence the crisis at the Sandoz plant and Monday night's emergency debate.

Falling ill or waiting for surgery already creates a great deal of stress. Imagine how patients across the country feel as they wonder whether their hospital will have the drugs needed for their surgery. Not to mention that patients in Gatineau, Quebec, will have to wait longer for surgery because of the Canada-wide shortage of injectable drugs. It is unbelievable that the shutdown of production at a single plant, the Sandoz plant in Quebec, could affect all Canadian provinces and territories.How has it come to this?

The provinces of Quebec, Ontario, British Columbia and Saskatchewan recently established a plan to manage the current shortage. They are working with the hospitals to verify drug inventories and identify alternative products. Some injectable drugs can be replaced by tablets or other products. However, changes in medications always pose risks. We do not know how the patient will react or if there will be any adverse effects. In short, it is truly a temporary solution.

At this time, Sandoz has resumed partial production of medications. However, the shortage could last months, or even a year, before supply is able to meet demand.

What is the federal government doing? It is reacting to the crisis instead of being proactive, and it is reacting too late. Yesterday, in a CBC interview, the director general of Health Canada's Biologics and Genetic Therapies Directorate confirmed that the agency was speeding up the licensing process to import essential drugs quickly. Health Canada must nevertheless ensure that these products comply with Canadian quality and safety standards. How will Health Canada inspect drugs and factories? Will it have enough people to do that?

Let us not forget that, in his fall 2011 report, the Auditor General found that in 2009 and 2010 the department was not proceeding with regulatory activities quickly enough and that it could take up to two years for new drugs to get through the review process. When the federal government is slow to approve new drugs, that has an impact on the entire supply chain.

Our motion calls on the government to expedite the review of regulatory submissions in order to make safe and effective medications available to the Canadian public. We are asking the federal government to play its part and ensure that, going forward, all Canadians have access to essential medications. This is particularly important for individuals waiting for cancer drugs; their lives are on the line.

These drug shortages occur regularly. In Quebec alone, in 2008, 38 drugs were out of stock; 63 were out of stock in 2009, and 116 in 2010. It makes no sense. It is only increasing; the situation is getting worse year after year. Contrary to what the government has said since the beginning of the crisis, it is responsible for some aspects of health care. The federal government is responsible for protection and regulation in health care, for example, the regulation of pharmaceutical products, food and medical devices. That is precisely what this crisis is about. The federal government is also responsible for consumer safety and disease surveillance and prevention.

The Canada Health Act is clear: Health Canada has a duty to regulate drugs and monitor their safety and quality. That comes under federal jurisdiction. Need I remind the House that, in our federation, both custom and the Constitution compel the federal government to co-operate with the provinces?

This government seems to have forgotten the basic principles of our country and the of Canada Health Act. Instead of blaming the provinces, it should sit down with them and with the pharmaceutical industry in order to establish a national strategy to anticipate, identify and better manage shortages of essential medications. That is exactly what we are proposing here today. And the official opposition is not the only one saying this. I would like to quote Dr. John Haggie, President of the Canadian Medical Association:

We need the federal government to use all of its leverage with pharmaceutical manufacturers, including economic inducements, to ensure Canadian patients get medicines they need.

The Canadian Cancer Society agrees:

The Canadian Cancer Society urges the federal Minister of Health to provide leadership to address this critical health care issue by:

ensuring there is mandatory listing of unavailable drugs by drug manufacturers;

developing early warning systems to identify potential drug shortages;

assisting hospitals and provinces in dealing with drug shortages.

Why does the federal government not want to legislate this? It is so quick to interfere in labour disputes, at Canada Post and at Air Canada, as it did yesterday.

Take, for example, the isotope shortage in 2007. The shutdown of the Chalk River reactor created a shortage of isotopes, products that are needed in the treatment and diagnosis of diseases such as cancer.

At the time, the Conservative government took immediate action to address the shortage. The federal government's inaction with regard to the current shortage flies in the face of the law and the government's jurisdiction, not to mention the Minister of Health's commitments. Yesterday, in the Standing Committee on Health, the minister said that sustainability will come from innovation and co-operation and that providing Canadians with the information they need is key to optimum population health.

I do not know whether she was listening to her own words, but she is not practising what she preaches. If all those principles are important to her, what is she waiting for to establish a mandatory reporting system in which pharmaceutical companies must disclose information about the supply of essential drugs. Patients' quality of life depends on it. It is all well and good for her to say that the mandatory registry is not a miracle solution—and that is true—but her current plan is completely ineffective.

Her answer therefore gives me the opportunity to say that the federal government needs to develop an effective and sustainable long-term plan to address the current shortages. The Ordre des pharmaciens du Québec is of the opinion that the federal government must also play a role to better manage drug supplies, and that this information is essential in order to prevent other shortages from happening in the future. Drugs are different from other consumer goods. No one chooses to be sick nor what the appropriate treatment will be.

In light of this crisis, it is urgent that the federal government finally demonstrate leadership to protect Canadians' health in the long term. The solutions are clear and simple. They are the three parts of our motion, which I will repeat: in co-operation with the provinces, territories and industry, develop a nationwide strategy to anticipate, identify, and manage shortages of essential medications; require drug manufacturers to report promptly to Health Canada any disruption or discontinuation in production; and expedite the review of regulatory submissions in order to make safe and effective medications available to the Canadian public.

This is the constructive, sustainable and concrete proposal being made by the NDP to eliminate the problem of drug shortages. I hope that the government will listen to reason and support this motion today.