Mr. Speaker, I appreciate the opportunity to speak to Bill C-51 today. This is an issue that deals with something of top concern to people across the country and certainly people in Vancouver Quadra, and that is the issue of health care. More importantly, health prevention and maintaining health is a critical part of what we do as people, families and mothers.
This bill speaks about not just protecting health from adverse issues through products that might be dangerous but also touches on how we can maintain our health and prevent health challenges by using natural products and complementary medicines, and using the medical system in a proactive and preventive way.
It is a very important bill which I am pleased to speak to. It touches on the protection of consumers from products that are tampered with or contaminated. It talks about protecting consumers. The products that they think they are buying and consuming need to be such products. There needs to be the ability to recall products that are problems and an important update to this legislation that is very out of date. From those perspectives, this is an important bill.
I will touch briefly on my background using complementary medicine. I, in fact, applied to become a naturopathic physician. Way back in my early career choices, I applied to the John Bastyr College of Naturopathic Medicine in Seattle having completed all of the prerequisite requirements to enter a college of naturopathic physicians. Since then, I have become a mother of three children and raised those children using almost exclusively complementary medicine.
Of course, the medicine provided by our MDs and hospitals has a very important role to play. When my daughter broke her leg, I was very grateful that there was an emergency department. I was able to take her in and she was given great care. She has healed properly and is able to climb mountains and plant trees without a problem.
The allopathic medical system also has an important place in our lives. However, so does complementary medicine. Using naturopathic physicians as primary physicians has been my family's choice. Using homeopathic remedies, traditional Chinese medicine, acupuncture, and a variety of alternatives has been an important part of maintaining the health of my family members.
From that perspective, I have been very concerned about possibly infringing on the choice that people might make to use naturopathic, complementary and other alternative modalities, and the products that they use, many of which have been used in traditional medicines for hundreds, if not thousands of years, and are important to maintaining health, preventing problems, and managing chronic diseases.
An additional aspect about the complementary medical system is that it tends to be supportive of people taking self-responsibility for their health, changing some of the lifestyle aspects that may not be conducive to their health, stepping forward to take responsibility in preventing problems by eating well, and using nutritional and herbal supports before there are clinical problems.
That self-responsibility is increasingly important in our society. As demographics change, the allopathic medical system is over-burdened with the demand on it and the costs are escalating, and taking larger and larger percentages of provincial budgets.
I have been listening to the concerns of people in my community of Vancouver Quadra from the perspective of the fines and enforcement measures in the proposed bill. I appreciate the member for Cambridge mentioning some of the amendments that the government was considering. I have also been listening to people from the Canadian Association of Naturopathic Doctors, both in British Columbia and nationally.
While I recognize that there are real concerns with this bill, notwithstanding Health Canada's attempts to reassure people that it would essentially change very little with respect to natural products, I want to flag some other concerns.
One of the concerns, of course, has to do with the intent to lump natural products in with therapeutic drugs. An article in The Vancouver Sun points out how completely unacceptable that would be. The article reports on a study which took place at the Vancouver General Hospital. It essentially concluded that 12% of patients who were rushed to the emergency room were there because of adverse affects from medications. The study findings were published that day in the Canadian Medical Association Journal. The 11 international authors of the study said patients with medication related complaints were more likely to be admitted to hospital beds after they had been seen in the emergency room and occupied those beds far longer than others, a result the authors described as striking. The study estimated that 70% of such visits were preventable through better prescribing, dispensing, and monitoring of patients.
I would like to quote from lead investigator Dr. Peter Zed, who was working at Vancouver General Hospital during the study but is now at the Queen Elizabeth Health Sciences Centre in Halifax:
We've proven in this study that we've got a problem in the health care system with patients who experience bad effects from medications and we have to figure out how to reduce those problems.
Problems stem from a variety of issues, including patients being prescribed the wrong drugs, given wrong dosages, having allergic interactions with drugs, and patients not following instructions for how and when to take their medications.
The key that one can take away is the fact that essentially one in nine emergency room visits at Vancouver General Hospital relate to pharmaceutical medications. This is a very different category of product than natural products such as herbs and traditional Chinese medicines.
Some adverse affects have been put forward by Health Canada. Members across the aisle have suggested that natural products and herbal medicines also can have adverse affects. I am not going to argue that there may be cases where a product is not 100% what it is claimed to be in the container or that there may be a contraindication with other medications people might be taking.
However, one in nine emergency room visits are due to pharmaceutical drugs versus the record of natural products, herbal medications, homeopathics, organotherapy, and other kinds of products that would be lumped in with pharmaceutical drugs in the bill as it reads now.
I am pleased to hear that amendments to create a third category are being considered, given that until very recently Health Canada was denying that there would be negative impacts from the way the bill was structured. I am going to be very vigilant in following the debate as this goes forward.
I have a letter from a constituent. Brian says:
I am writing to you as one of your constituents to express my concerns about Bill C-51 and the impact it will have on the ability of my naturopathic doctor to treat my health concerns safely and effectively as well as my access to natural health products that I currently purchase. As an informed patient, I have chosen to be treated by a naturopathic physician utilizing natural therapies and substances to ensure optimal health. I would like some assurances that my choice to see a naturopathic doctor or purchase natural health products in the store will not be negatively affected by Bill C-51.
I am focused on the response of the naturopathic physician community because that is where my knowledge is strongest and those concerns remain.
I have a public posting from a naturopathic physician in Nelson, B.C., who is the current president of the College of Naturopathic Physicians of British Columbia, Dr. Lorne Swetlikoff. He acknowledges that:
--Bill C-51 appears well intended and seems to strengthen the manner in which all health products will be regulated. [However] as you delve into the details of the bill you discover the potential for disaster [that] it poses for the practice of naturopathic medicine in Canada.
A couple of the examples of the concern that is being raised by the naturopathic community is that:
The bill introduces a new term called “prescription therapeutic products” to refer to any product, including a natural product that is not included under the current natural health product regulations and states that they will be accessible only by a “practitioner”.
However, of great concern to Dr. Swetlikoff and other naturopathic physicians is that:
--under this bill, prescription therapeutic products require a prescription from a “practitioner”. Currently naturopathic doctors do not have prescribing authority and are not designated as a practitioner in Canada [under our federal laws].
So, essentially, that would mean that there would be many products that naturopathic physicians utilize to maintain the health, to protect and prevent problems, of their clients, and to manage chronic diseases, that would no longer be accessible to them. Of course, they could be prescribed by an MD, but medical doctors are actually not trained to utilize those kinds of herbal and non-pharmaceutical drug products. So, they could become inaccessible.
I think it is critical to understand that this does affect many patients because many people use the services of naturopathic physicians. They are physicians who have been trained seven-plus years in post-secondary institutions and to now say that a naturopathic physician can no longer prescribe a patient to use a herb like St. John's wort is completely outrageous. That area needs to be addressed as the bill moves forward.
I had the privilege of having worked with the provincial government when I was in cabinet between 2001 and 2005 to raise the profile of complementary medical modalities and the effectiveness of those modalities on prevention and chronic disease management, and the need of additional professionals to take care of patients who in my province of British Columbia have a shortage of family doctors available. So, it is very important to integrate complementary and alternative medicine into our health care system and not to isolate it and marginalize it.
So, in British Columbia I worked with the government and the naturopathic association to ensure that we in British in Columbia have a broader scope of practice for naturopathic physicians that better reflects the kinds of services that they are trained to provide. I am pleased that recently a law was passed that supports a scope of practice that will allow those physicians to prescribe, to have hospital privileges, to refer to specialists, and to request laboratory procedures for their patients.
That is a step toward integrating naturopathic and other alternative medical practitioners into our health care system, which is exactly what we need so that people can have choice, so they are not isolated, so that there is not a duplication where a patient needs to see a naturopathic physician and then has a whole different track to see an MD because of the historic separation between those practices.
Integrating them is very important. I have been pleased and privileged to be able to work toward that in British Columbia, but it is not the case in all provinces. In provinces where a naturopathic physician cannot prescribe, Bill C-51 would unfortunately and very negatively curtail the ability of naturopathic physicians and other complementary physicians to provide proper care, service and support to their patients.
I was also pleased to hear about the proposed amendments. The member for Cambridge described some of them.
We need to ensure as the bill moves forward that there is proper consultation, and not just consultation but incorporation of the views and the requirements of the different stakeholders that have an interest in this. I would contend that this has not happened adequately or we would not have had this great amount of concern and fear on the part of the public, a fear that to some degree I have shared.
I have been working with naturopathic physicians, as I have said, but also with people who represent the manufacturers, the importers, the distributors, the wholesalers and retailers of these health products, to make sure we understand which of these concerns are valid. Substantially, these concerns are valid. We should move forward in a way that fully addresses them, that does not just window dress this by hearing them and then moving forward with a bill that overregulates a sector whose products have demonstrated very little harm.
I will repeat what I said in my introductory remarks, which is that consumer safety is an important role of government. That is part of what we do. We regulate and legislate to protect consumers from demonstrated harms, but as a society we have to always balance between that kind of protection and an overregulation which would cast a net so broadly that it would bring in products and issues that really have not been demonstrated to be harmful to the people who choose to use them.
I would say that is what Bill C-51 does. By casting such a wide net, it actually risks doing more harm than it prevents, by frustrating people who are taking responsibility for their health, and by applying huge fines, which might be appropriate in the case of a billion dollar pharmaceutical firm but not in an industry in which the largest players are much smaller. That kind of draconian compliance and enforcement tool is simply not appropriate in the natural products category whereas it might be in the pharmaceutical drug category.
I am pleased to be able to participate in this debate. I will be taking an active interest and involvement at the caucus committee, where my colleagues will discuss this, and also at the parliamentary committee. I intend to be a visiting member and ensure that the naturopathic physicians' concerns, as well as the concerns of other stakeholders, are clearly articulated.
I will do what I can to ensure that they are incorporated so that as we move forward Bill C-51 does what it is intended to do, which is to be a positive and important tool in protecting the safety and well-being of the consumers of the products it covers without overregulating and creating barriers to the use of those natural products that are so important to so many of us.
