Bill C-442 (Historical)

National Lyme Disease Strategy Act

An Act respecting a National Lyme Disease Strategy

This enactment requires the Minister of Health to convene a conference with the provincial and territorial ministers responsible for health and with representatives of the medical community and patients’ groups for the purpose of developing a national strategy to address the challenges of the recognition and timely diagnosis and treatment of Lyme disease. It also authorizes the Minister of Finance to establish guidelines in respect of the allocation of funding to provincial and territorial governments that have enacted legislation to implement that strategy.

Federal Framework on Lyme Disease Act

[Libby Davies, NDP, Vancouver East, BC]

Mr. Speaker, I am pleased to rise in the House today to speak in support of third reading of Bill C-442 for a national framework for Lyme disease.

Today is a special day. It is not every private member's bill that gets to third reading. The fact that this bill has means that it has stood the test. It has gone through the challenges of going through second reading, going to committee, through amendments, and here it is back in the House. We are anticipating and hopeful that the bill will be approved today in the House of Commons and then go to the Senate.

I would like to speak briefly to the bill, but I would first like to congratulate the member for Saanich—Gulf Islands for the hard work that she has put into this bill, into building alliances and talking to people in different parties. It is a good example of the goodwill and the solidarity that can develop around an issue when people recognize that something needs to be done. I only wish it would happen more often in the House. There are so many issues that need our attention, collectively, with a spirit of fair play and goodwill. Maybe this bill will be a good model for that, but I wish it would happen a little more often.

When this bill came to the health committee, I was pleased to be there. We went through it and heard witnesses. Hearing the witnesses was incredibly compelling. We heard from Jim Wilson of the Canadian Lyme Disease Foundation. People shared personal experiences about this disease, which is not easy to do in a formalized parliamentary hearing as a witness with all of the official trappings that go along with that.

Chris Powell and her daughter Nicole were quite remarkable. Nicole, who is from British Columbia, was quite remarkable in sharing her experience of having Lyme disease and the suffering she was going through. It is not only physical suffering, which she still endures, but also the emotional anguish of not being able to get a proper diagnosis.

One of the critical elements of the bill is that it would bring together the different elements we need in terms of not only prevention and better public awareness, but a medical community that is in a much more heightened state of awareness with respect to Lyme disease, as well as better clinical diagnostic tools and testing.

We heard horrifying stories from people who had gone to extraordinary lengths to find out why they were so sick and why they could not get help. We know there are two tests available in Canada, but they pertain only to basically one strain of the tick that produces Lyme disease. There is so much that needs to be known.

We heard stories about the amount of money people had spent to go to the United States, for example, where other testing has been available, to finally get a correct diagnosis. Then they would come back to Canada and have somebody contradict that diagnosis. It a nightmare for these people to live through, not just enduring and living with the disease, but coping with systemic barriers and obstacles to proper diagnosis and get the treatment they need. We heard all of that at committee. It was compelling and it made us all acutely understand that we needed a national framework.

I want to spend a moment on that. As the health critic, I meet with many organizations across the country, in Ottawa, in my riding and elsewhere. There are so many issues and people are literally begging the federal government to show leadership to develop a national strategy, whether for dementia or Alzheimer's. This is just another example of that. It is a reflection of our complex system.

We know that health care is a provincial delivery system. There is no question about that. However, there is a necessity for federal leadership. Under the Canada Health Act, we have a duty and responsibility to ensure that all people in our country, whether rich or poor or whether they live in the north, south, east, west or the centre, in small communities or large urban centres, have accessibility to our health care system. We know the inequities are getting greater, and not just between provinces but also within provinces.

There is an overarching issue that the bill also reflects, which is that we need to see the federal government be at the table. We need to see the federal government take leadership on these issues. Many groups are calling for a national strategy. People know the reality of this kind of scattered approach. It is like a patchwork across the country and that just is not good enough.

The bill speaks about a federal framework and would bring together the players. As the member for Saanich—Gulf Islands has outlined, a key element of the bill is to convene a conference and include people who have Lyme disease and advocates so they are at the table as well. It is really about trying to bring the players together to develop that national framework.

We also heard at committee very interesting testimony from representatives of the Public Health Agency of Canada. They told us that Lyme disease had been a reportable disease only since 2009. We are only beginning to get a sense of the numbers out there. Of course many cases are not reported. Either people do not know they have the disease or if they suspect it, they do not get a proper diagnosis.

I agree with the member that we will face an explosion of cases, particularly with climate change and a warming environment. In southern Canada and places like B.C., where we really have not seen that many cases of Lyme disease, this will be on the increase.

I was very interested to hear that the Public Health Agency of Canada was conducting a fairly major public awareness campaign. In fact, the people from the agency assured us that Lyme disease should be a household word by the end of summer. People would know what it was, what they needed to be aware of and what they should do. I hope they are right because we do not want to see anybody suffer through this.

The issue of testing is very important. We heard loud and clear that there was an inadequate testing procedure in Canada. We need to have much better availability of testing with a greater depth of testing for different kinds of bacteria and strains.

Then finally on research, the Canadian Institutes of Health Research told us that some very good research was going on in Canada. I believe one of the researchers was in Calgary and another was maybe in Ontario. We need to fund that research. We need to know about the different strains so people can receive the appropriate diagnostic analysis and treatment.

The New Democrats have been very happy to support this bill all the way through. We are critically aware of this issue. It is something we speak about with our constituents. I am sure many of us have had visits from our constituents who have been affected by Lyme disease.

At the end of the day, we owe gratitude and thanks to the Lyme disease Foundation of Canada, which has done incredible work on this and has never given up. It is not easy. We have resources here. We can bring forward a private member's bill, which I do not want to diminish as it has a very important part. However, what is really wonderful is the fact that the people in the community, those who themselves are suffering, pushed this boulder uphill. They did not give up and they compelled us as legislators to take on this issue and support it.

Finally thanks go to those advocates. We need to remain vigilant and monitor what goes on to ensure this framework becomes a strategy that will help people.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I am glad that the hon. member for Vancouver East took a moment or two to put the question so that I could pull myself together. I am quite overwhelmed and very grateful.

I appreciate that there were changes made at committee. I do not believe that they take anything away from the thrust of the bill, but as with any piece of legislation, we will have to remain vigilant.

I know that the current Minister of Health is very committed to this, but the bill will require initiatives from the Minister of Health to hold a conference. That conference will gather expertise from the health and medical community and the Lyme disease patient community and, of course, engage at some level the federal, provincial, and territorial ministers for health.

One amendment changed that process from a six-month mandatory window from the point of passage to twelve months in order to incorporate and provide flexibility for the fact that Bill C-442 would mandate ministerial consultations at a very significant level.

We just have to commit that there is goodwill here. There is an intention to make a difference for people. We have all learned a great deal from the Lyme disease patient community. There are people whose lives have been cut short. They cannot do the job they used to do.

One of the most heartbreaking cases in my own riding is that of a young man who wrote to me and who I saw on Boxing Day. He had not been well enough to come down the corridor on Christmas morning to watch his girls open up their Christmas presents.

The sense of urgency is with us. In the spirit of goodwill, we will monitor this bill and keep pushing in a friendly fashion. We will not let the bill just sit on a shelf. I believe that is the motivation of the Minister of Health, as it is for my hon. colleague, the official opposition health critic.

The House proceeded to the consideration of Bill C-442, an act respecting a federal framework on Lyme disease, as reported (with amendments) from the committee.

Concurrence in Vote 1--Senate

[Michelle Rempel, Conservative, Calgary Centre-North, AB]

Mr. Speaker, going back to this particular example, my colleague from Saanich—Gulf Islands introduced this legislation in the House in accordance with the precedents set on private members' bills. I believe the bill is coming up for debate shortly.

The bill will be debated here at second reading stage and will go to committee. Many of the stakeholders that my colleague has consulted on the bill will provide their input at committee stage. I hope that we have great debate on this particular bill. Should the bill be supported in the House, where would it go to become law? What is the next step in this process?

If we go back to what I just went through, which is publicly available and part of any civics lesson, the bill will go to the Senate for the next stage of review, and then royal assent. That is how the legislative process in Canada works. In order for Bill C-442 to become law, the Senate needs to be funded in order to pass it.

Not putting this vote forward in the estimates means that the NDP is voting to shut down the legislative process in this country. It is as simple as that.

We can have an extensive debate on Senate reform and how senators should be elected and so on, but that is not the subject of the debate tonight. The NDP has proposed to shut down the legislative process in Canada. For all of the democratic woe is us, for all of the democracy in Canada is this and that and what not, we have before us a suggestion to shut down the legislative process in Canada.

We are late in the session. Many of us want to be in our ridings connecting with our constituents. We should all give pause for thought as to what that means. It means that if legislation from the House cannot be passed, then it cannot be enacted. It means that next year, the routine process of government that goes through the Senate would not happen. Whether one agrees with Senate reform or abolition or however a member thinks we should seek to change it, the reality remains that not voting this particular piece forward means we cannot put government legislation through.

I have been listening to the questions and answers tonight. We have had a lively debate on how we could possibly make the Senate more accountable to Canadians; that is subject matter worthy of debate, but it is not the substance of what is being debated right now. Sometimes we lose sight of that.

I would ask my colleagues across the way just to have a think. The NDP has put forward a few private members' bills over the years, not just in this session, that have achieved consensus in the House. How do they become law? They become law by going through the Senate. This is part of Canada's Constitution.

The vote on the estimates that has been put forward here is for this upcoming fiscal year. Our government asked for a Supreme Court opinion on what we could and could not do in the House in terms of scope for Senate reform. We were obviously quite disappointed with the outcome of that decision. That said, my colleague the Minister of State for Democratic Reform has talked about how we as a government will press forward on this particular issue because it is something of concern to Canadians. We also have to look at this upcoming fiscal year, which is the subject matter of the estimates.

I would like to see government continue to operate because I would like to see legislation continue to go through the House. I hope that my colleagues will give pause for thought on this one and support Vote 1, because the reality is that this is part of Canada's Constitution. We need to separate the debate around how we could reform the Senate, which again is worthy of debate, from the reality of this particular motion.

I could go through numerous bills in terms of how this particular vote would affect them. The Senate right now has a very heavy legislative calendar. Many of the committees are tasked with a review of bills that have come from here.

Certainly my colleagues opposite would say that there is support for some or all components of some of these bills. I would like to see those bills passed. I would like to see that process continue to operate, which is why we support Vote 1 in the estimates. It is because constitutionally we need the Senate to operate in order for legislation to be passed.

It is very short-sighted for us as a House to sit here and say we cannot fund the Senate and that we are going to pull the funding from it. How, constitutionally, would we put legislation through? I just do not understand this. It is actually a little mind-blowing that the substance of this situation has not come up. Constitutionally, the Senate has to operate. Certainly in the next fiscal year, even if we work at lightspeed beyond the speed of government, the Senate has a job to do right now, and certainly we would all say that we should continue to support it.

Because the topic of Senate reform has come up in debate tonight, I would like to take this opportunity, because I have been itching to do so for a few months, to talk about the approach to Senate reform of my colleagues in the Liberal Party. I find it a bit disingenuous for the senators who consider themselves Liberals in their caucus to all of a sudden walk out and say that they are not Liberals anymore.

[Michelle Rempel, Conservative, Minister of State (Western Economic Diversification)]

Mr. Speaker, it is a pleasure to address the House and anyone who might be in the gallery tonight on a beautiful summer evening in Ottawa.

We need to be clear on what we are talking about tonight, what the substance of the debate is. It is my understanding that my colleague from Winnipeg Centre gave notice of opposition to Vote 1 in the estimates, which is an amount of approximately $57 million under “The Senate—Program expenditures, in the Main Estimates for the fiscal year ending March 31, 2015”.

What does this mean? It means that this amount is part of the amount that the Senate uses to conduct its operations. There has been a lot of important debate tonight about changes in the Senate, about how we could reform the Senate, about how the Senate could act in a more transparent manner or be more accountable to Canadians. These are important, weighty issues.

I have certainly been quoted in the media. My opinions about the need for Senate reform are on the public record. When I go out to talk to my constituents, it is an issue. How do we make the folks who are responsible for legislation in this country more accountable to Canadians? There are several senators who would agree that this body should be made more accountable. This is a topic of debate.

Going back to what we are talking about tonight, it is the allocation for this upcoming fiscal year for the operations of the Senate. I am going to take a moment, because I have some time tonight, to read an article that is on the Parliament of Canada website. It is entitled “Making Canada's Laws”. It states:

...Canada's Constitution states that both the Senate and the House of Commons must approve bills separately in order for them to become law. Legislative basics The lawmaking process starts with a bill — a proposal to create a new law, or to change an existing one. Most of the bills considered by Parliament are public bills, meaning they concern matters of public policy such as taxes and spending, health and other social programs, defence and the environment. A bill can be introduced in the House of Commons (C-bills) or the Senate (S-bills), but most public bills get their start in the Commons. A bill goes through certain formal stages in each house. These stages include a series of three readings during which parliamentarians debate the bill. Prior to third and final reading, each house also sends the bill to a committee where members examine the fine points of the legislation. Committee members listen to witnesses give their opinions on the bill, and then subject it to clause-by-clause study based on the testimony. Either house can do four things with a bill: pass it; amend it; delay it; or defeat it. Sometimes, one house refuses changes or amendments made by the other, but they usually both agree eventually. All laws of Canada are formally enacted by the Sovereign, by and with the advice and consent of the Senate and the House of Commons. Once both houses have approved a bill, it is presented for Royal Assent and becomes law.

Just to recap, how does a bill become law? It passes through the first House—sometimes the Senate, but usually the House of Commons—and it passes through the second House—usually the Senate, but sometimes the House of Commons—and then royal assent is given by the Governor General.

How does it pass through a House? It goes through first reading, when the bill proposing a law is received and circulated. At second reading, the principle of the bill is debated to verify that the bill represents good policy, et cetera. Then it goes through committee stage. Members of the public appear as witnesses to comment. At report stage, the committee report is considered by the whole House. Third reading is final approval of the bill, and the bill is either sent back to the other House or set aside for royal assent.

As a recap on how the legislative process works here, right now, for this fiscal year, we require both Houses in order to pass legislation. I actually do not think anyone here can argue that, and if they do, they need to have a refresher course prior to continuing their activities in the House. We need to have both sides under our Constitution right now.

The subject of the debate tonight is whether we should or should not approve funding for the upcoming fiscal year to keep the government operational. To put this in a real-life context, there is opposition on this particular vote. If this vote in the estimates were to be defeated, what would that mean in a real-life context?

A bill is coming up that my colleague from Saanich—Gulf Islands is keen on, because she proposed it. I am talking of Bill C-442, an act respecting a national Lyme disease strategy. It had first reading in the House on June 21, 2012, according—

Business of the House

[Peter Van Loan, Conservative, Leader of the Government in the House of Commons]

Mr. Speaker, I will start with the concept of the very strange proposition put forward by my friend. He uses this concept of shifts and believes there is some perverse obligation on the part of the government that, if the opposition wishes to filibuster the production of new laws and delay their production, we somehow have an obligation to match them step for step in extending that process. His comparison is with ordinary Canadians. He said that ordinary Canadians should not produce a product at the end of the day at work; they should take two, three, or four days to get the same thing made. That is his idea of getting things done. That is his idea of how ordinary Canadians can work. I think that says something about the culture of the NDP and the hon. member. I will let members guess what culture that is. It is a culture that does say we should take two or three times longer to get something done or to get to our destination than we possibly can.

We on this side are happy to make decisions to get things done for Canadians. In fact, that is exactly what we have been doing. Since I last rose in response to a Thursday question, the House has accomplished a lot, thanks to our government's plan to work a little overtime this spring.

I know the House leader of the official opposition boasts that the New Democrats are happy to work hard, but let us take a look at what his party's deputy leader had to say on CTV last night. The hon. member for Halifax was asked why the NDP agreed to work until midnight. She confessed, “We didn't agree to do it.” She then lamented, “We are going from topic to topic. We are doing votes. We are at committees. They are really intense days. We're sitting until midnight.”

On that part, I could not agree more with the deputy leader of the NDP, believe it or not, but with much more cheer in my voice when I say those words, because we think it is a good thing. These are intense days. We are actually getting things done. We are actually voting on things. We are actually getting things through committee. For once, we are going from topic to topic in the run of the day.

Let me review for the House just how many topics, votes, and committee accomplishments we have addressed since the government asked the House to roll up its sleeves.

Bill C-24, the strengthening Canadian citizenship act, was passed at second reading and has even been reported back from the citizenship committee.

Bill C-10, the tackling contraband tobacco act, was concurred in at report stage and later passed at third reading.

Bill C-31, the economic action plan 2014 act, no. 1, was reported back from the finance committee.

Bill C-27, the veterans hiring act, was passed at second reading.

Bill C-20, the Canada-Honduras economic growth and prosperity act, was concurred in at report stage.

On the private members' business front we saw:

Bill C-555, from the hon. members for West Nova in support of the seal hunt, was passed at second reading.

Bill C-483, from my hon. colleague, the member for Oxford, cracking down on prisoners' escorted temporary absences was passed at third reading.

Bill C-479, from the hon. member for Ancaster—Dundas—Flamborough—Westdale, on improving the place of victims in our justice system was passed at third reading last night.

Progress is not limited to Conservative initiatives. The Green Party leader's Bill C-442, respecting a Lyme disease strategy, was reported back from committee yesterday.

The hon. member for Timmins—James Bay saw a motion on palliative care pass.

We have also seen countless reports from committees reviewing the government's spending plans, as well as topics of importance to those committees.

This morning we even ratified the appointment of an officer of Parliament.

Finally, I do want to reflect on the accomplishment of Bill C-17, the protecting Canadians from unsafe drugs act (Vanessa's law), which members may recall me discussing in last week's Thursday statement. It finally passed at second reading. However, this did not happen until the NDP relented and changed its tune to allow the bill to go to committee. It was the first time ever that we had an expression from the New Democrats when we gave notice of intention to allocate time in which they said, “We don't need that time; we're actually prepared to allow a bill to advance to the next stage”. I think, by reflecting on the fact that those dozens of other times the NDP did not take that step, we could understand that they did not want to see a bill advance; they did not want to see progress made. That lets Canadians understand quite clearly why it is we need to use scheduling and time allocation as a device to get things done in the face of a group that thinks the objective is to fill up all possible time available with words rather than actual votes and getting things done.

It is clear that our approach is working. We are getting things done in the House of Commons and delivering results for Canadians.

Perhaps I might be overly inspired by the example of Vanessa’s Law, but I do want to draw the attention of the House to Bill C-32, the Victims Bill of Rights Act.

So far, we have seen three days of debate on second reading of the bill, but “debate” is actually not accurate. What we have witnessed is speech, after speech, after speech—most of them from New Democrats—offering platitudes of support for the idea of getting that bill to a committee where it could be studied. What I want to know is, why will they not just let it happen? Victims of crime want to see meaningful action, not just kind words.

Suffice it to say that I will need to schedule additional time for discussion of this bill. Perhaps the NDP will let it pass after a fourth day of talk.

This afternoon, we will continue with the report stage debate on Bill C-31, our budget implementation bill. When that concludes, we will turn to Bill C-20, to implement our free trade agreement with Honduras, at third reading. If time permits, we will continue the third reading debate on Bill C-3, the Safeguarding Canada's Seas and Skies Act.

Tomorrow morning, we will start the report stage debate on Bill C-24, which makes the first modernization of the Citizenship Act in 35 years. After question period, I will call Bill C-32, the Victims Bill of Rights Act, to see if the NDP is ready to deliver results, not talk.

Monday morning, we will continue the third reading debate on Bill C-20, if more time is needed, and then resume the second reading debate on Bill C-18, the Agricultural Growth Act. After question period, we will get back to the Strengthening Canadian Citizenship Act.

Tuesday shall be the eighth allotted day when the NDP will have a chance to talk, and talk, about a topic of their own choosing. At the end of the night, we will have a number of important votes on approving the funds required for government programs and services and pass two bills to that end.

On Wednesday, we will debate our budget bill at third reading, and then we will start the second reading debate on Bill C-36, the Protection of Communities and Exploited Persons Act, which my seatmate, the Minister of Justice, tabled yesterday.

We will continue the debates on Bill C-36 and Bill C-24, if extra time is needed, on Thursday. After those have finished, and on Friday, we will resume the uncompleted debates on Bill C-3, the Safeguarding Canada's Seas and Skies Act, at third reading; Bill C-6, the Prohibiting Cluster Munitions Act, at report stage; Bill C-8, the Combating Counterfeit Products Act, at third reading; Bill C-18, the Agricultural Growth Act, at second reading; Bill C-26, the Tougher Penalties for Child Predators Act, at second reading; Bill C-32, the Victims Bill of Rights Act, at second reading; and Bill C-35, the Justice for Animals in Service Act (Quanto's Law), at second reading.

To make a long story short, we have accomplished much in the House over the last week, but we still have much left to do, which inspires me to note that in the week ahead I have to take my automobile in for maintenance. At that time, when I take it to the dealership, I hope one person will work on it for an hour, get the job done, and then return it to me at a reasonable cost. I do hope I am not told, “There are still many more employees who have not had a chance to have a shift working on your car as well, so we are going to keep it here another three days and give everybody a turn to work on your car.” I hope the dealership will do as Conservatives do: get the job done and then deliver me the product.

Health

[Ben Lobb, Conservative, Huron—Bruce, ON]

Mr. Speaker, I have the honour to present, in both official languages, the fourth report of the Standing Committee on Health in relation to Bill C-442, An Act respecting a National Lyme Disease Strategy. The committee has studied the bill and has decided to report the bill back to the House with amendments.

[The Chair, Conservative, Ben Lobb]

That covers what we needed to do, and we're five minutes ahead of our plan, so we'll consider Bill C-442 dealt with and we'll report it back in due course.

Ms. May has a short comment, and then we're going to go in camera.

Go ahead.

[Eve Adams, Conservative, Mississauga—Brampton South, ON]

Mr. Chair, we move that Bill C-442 in clause 3 be amended by (a) replacing lines 12 to 14 on page 3 with the following:

3. The Minister must, no later than 12 months after the day on which this Act comes into force, convene a conference or otherwise engage with the provincial and territorial ministers and

And (b) replacing line 18 on page 3 with the following:

federal framework that includes

And (c) replacing line 21 on page 3 with the following:the Agency to

And (d) replacing lines 26 to 29 on page 3 with the following:management of Lyme disease, and the sharing of best practices throughout Canada;

And (e) replacing, in the French version, lines 6 and 7 on page 4 with the following:

nationale et d'en améliorer la prévention, l'identification, le traitement et la gestion.

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

I have one last question to you before I turn to Dr. Ouellette.

Having looked at Bill C-442, I don't think any bill is perfect at first reading. Are there things in it that you'd like to see improved that are not currently before us in government-recommended amendments?

[Steven Sternthal, Acting Director General, Centre for Food-borne, Environmental and Zoonotic Infectious Diseases, Infectious Diseases Prevention and Control Branch, Public Health Agency of Canada]

Good morning.

Thank you, Mr. Chair and members of the committee, for the opportunity to contribute to your deliberations on Bill C-442.

I am pleased to be here today to address the work under way in the Public Health Agency of Canada to reduce Lyme disease across the country.

I'll begin by addressing the agency's role and how it applies to Lyme disease.

The agency aims to promote better overall health of Canadians by preventing and controlling infectious diseases. We undertake primary public health functions, such as health promotion, surveillance, and risk assessment. These inform evidence-based approaches to prevent and control the spread of infectious diseases.

As part of its public health leadership role, the agency coordinates the national surveillance on Lyme disease as one of the most rapidly emerging infectious diseases in North America. I know that was part of your deliberations late last week.

The spread of Lyme disease is driven, in part, by climate change, as the tick vector spreads northwards from endemic areas of the United States. Moving into Canada, it is impacting our most densely populated regions. Based on the lessons learned in the United States, we anticipate the disease will affect over 10,000 Canadians per year by the 2020s.

To date, we have seen cases increase from 128, in 2009, when Lyme disease became a nationally notifiable disease, to an estimate of over 500, in 2013. That's a fourfold increase in just over five years.

However, this national snapshot only reflects a portion of all cases in Canada. This is because some people do not seek treatment for milder symptoms. Others do seek medical help, but may be misdiagnosed because their doctors are not always aware of the range of symptoms, or even that Lyme disease is in Canada. Agency risk models estimate the true number of infections to be at least three times higher than what has been reported today.

To support physicians in diagnosing Lyme disease, laboratory diagnostic testing is available across Canada in various public health laboratories. Like the United States, we use a two-tier test that must be requisitioned by a physician: the ELISA, to screen; and the western blot, to confirm Lyme disease.

The following are just a few facts about the testing in Canada.

Last year, almost 40,000 ELISA tests were administered by provincial and national laboratories. Of this total, approximately 3,000 tested positive or inconclusive, and were sent on to have essentially the second part of the screening and testing, the western blot, for confirmation of Lyme disease, by either our National Microbiology Laboratory in Winnipeg, or by public health laboratories in Ontario and British Columbia.

Following a thorough review of this surveillance information, available domestic and international research, stakeholder views, and existing public health messaging on this important topic, the agency has put in place an action plan to prevent and control Lyme disease in Canada. The action plan identifies three pillars for concrete action: engagement, education, and awareness; surveillance, prevention, and control; and research and diagnosis.

The first pillar includes a comprehensive public awareness plan that focuses on educating health care professionals and the public about Lyme disease.

Raising awareness among health professionals is one of our main goals: informing them that Lyme disease is here, educating them on symptoms, and encouraging them to properly diagnose and report cases.

This year, we have already reached an estimated 200,000 health professionals with awareness posters published in medical journals beginning in March. We have also presented to clinicians at a variety of venues across Canada in recent months.

We are also using every means available to get the message out to the general public. From social media, to Google AdWords, to partnering with organizations like The Weather Network, we are telling Canadians that Lyme disease is here, how to recognize it, and how to protect themselves from it. These public messages will continue throughout the summer period, which really is the Lyme disease season in Canada.

The agency has also worked with provincial and territorial public health authorities, as part of the Pan-Canadian Public Health Network, to develop a coordinated, vector-borne disease communications strategy, and public awareness tools targeting Lyme disease.

We hope that by the end of this year's tick season Lyme disease will be a household term.

I would now like to address the second pillar, which focuses on innovative ways to conduct surveillance and encourage preventive behaviour.

Efforts made in Lyme disease surveillance are starting to show some results. This year the majority of provinces are providing detailed case information, which will help identify new areas where Lyme disease is endemic and assist provinces in tailoring their preventive strategies.

The information will also provide a clear picture of the signs and symptoms of Lyme disease, information that is key for clinicians to properly diagnose it.

The final pillar focuses on increasing lab capacity, testing new diagnostic methods and carrying out research to generate new insights into effective diagnosis and treatment.

Under this pillar the agency is increasing testing capacity and quality by using state-of-the-art laboratory equipment. We recognize the challenges with current testing, particularly around detecting early Lyme disease, as the human body takes some time to develop antibodies to the bacteria.

The agency is committed to improving diagnostic testing. New methods are being evaluated and any that outperform current methods, the two-step method, will of course be adopted.

In the meantime we continue to recommend doctors diagnose patients on the basis of a full, wholesome, clinical assessment.

We recognize that laboratory technologies have evolved and will continue to do so in the future. The agency's national microbiology laboratory, in collaboration with the Canadian Public Health Laboratory Network and other stakeholders, will be updating our laboratory diagnostic guidelines in the near future.

However in doing so the agency faces a challenge. We can update the guidelines to reflect the current available evidence, but new evidence is needed to inform new diagnostic and new treatment methods. Therefore the agency is committed to continuing to work with medical professionals, patient advocacy groups such as the Canadian Lyme Disease Foundation and the Canadian Institutes of Health Research, and my colleagues on the video conference today to identify and address research gaps.

In closing, I would like to restate that the goal of the agency is to mitigate the impact of Lyme disease on Canadians. Through our collective efforts, Canadians will become more aware of the disease, how to recognize its symptoms, and the benefits from early treatment.

Together, we can reduce the severity of Lyme disease in Canada.

Thank you for your attention.

[The Chair, Conservative, Ben Lobb]

Good morning, ladies and gentlemen. Welcome back.

We're studying Bill C-442 in our final meeting on it. We're going to get right at it. We have two witnesses here today. We have the Institute of Infection and Immunity. There were a few problems with the connection but we are connected now. So we're going to go right ahead with Mr. Ouellette.

You have 10 minutes for your presentation. We'll just carry on. Can you hear us okay, sir?

Lyme Disease

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I rise to present two petitions. I am extraordinarily heartened to present over a thousand names of Canadians from coast to coast in support, as are all the parties in the House of Commons, of Bill C-442, an act to create a national strategy on Lyme disease. Thousands of Canadians are asking for our help.

Earlier this morning in the health committee I spoke to this. We have such strong support from across the country and around the House, so let us get on with it.

[The Chair, Conservative, Ben Lobb]

Thanks very much.

Unfortunately, we've come to the end of our two hours. This will conclude our first meeting on Bill C-442. I look forward to seeing everybody else here on Tuesday.

Thank you again to our guests for taking the time to be here and for providing your information.

Thank you. This meeting is adjourned.

[Jim Wilson]

CanLyme supports Bill C-442, and our preference is that the wording not be changed to reflect best practices over standard of care. The term best practices has been used far too many times to justify the wrong directions.

Besides, what purpose does the term best practices serve other than to make a claim of excellence and highest standards? History shows us the term was used to hide behind or to ignore contradictory research and opinion. Do we need that again? Ask yourself why.

Thank you.