Bill C-237 (Historical)

National Framework for Diabetes Act

An Act to establish a national framework for diabetes

This enactment provides for the development of a national framework designed to support improved access for Canadians to diabetes prevention and treatment.

National Framework for Diabetes Act

[Sonia Sidhu, Liberal, Brampton South, ON]

moved that Bill C-237, An Act to establish a national framework for diabetes, be read the second time and referred to a committee.

Madam Speaker, it is an honour to speak to my private member's bill, Bill C-237, an act to establish a national framework for diabetes in Canada. I would also like to thank the member for Winnipeg North for seconding the motion to introduce my bill.

I could not be happier to be debating my bill during November, which, as many may know, is Diabetes Awareness Month.

Over 11 million Canadians live with diabetes or prediabetes. A new case is diagnosed every three minutes and 90% of these cases are type 2, which means they can be prevented through better awareness, education and lifestyle changes. This disease is the cause of 30% of strokes, 40% of heart attacks, 50% of kidney failure requiring dialysis and 70% of non-traumatic low-limb amputations. This is the harsh reality. In the Peel Region alone, which I am proud to call home, the rate of diabetes more than doubled between 1996 and 2015.

Some Canadians are at increased risk of diabetes, including South Asians, the indigenous population and Métis people. We also know that diabetes disproportionately affects Canadians with low incomes and education.

Complex public health challenges, such as chronic diseases like diabetes, cannot be addressed with a single-solution approach. No organization, institution or sector of society acting alone can solve this challenge. All segments of society, including communities, academia, government, the charitable and not-for-profit sectors, and the private sector must work together if we are to be successful. That is why the bill mandates that the Minister of Health work in collaboration with provincial health leaders, indigenous communities and other stakeholders to develop a national framework designed to support improved access to diabetes prevention and treatment to ensure better health outcomes for Canadians.

In many cases, diabetes is preventable. We know that individuals who have a moderate to high level of physical activity, who eat a healthy diet and who do not smoke are 82% less likely to be diagnosed with diabetes. Having been a health care professional for over 18 years, I have seen first-hand how a healthy diet, staying active and exercising can all contribute to the prevention of this disease. Let us combat diabetes and its life-threatening complications by making Canadians familiar with diabetes warning signs, encouraging healthy lifestyle choices and making it possible to access the best possible care.

It is estimated that this year the cost of hospital care and drugs for diabetes will amount to approximately $30 billion. This is a massive burden on our public health care system, but the costs do not end there. Whenever a Canadian suffers a stroke or a heart attack, that is an additional cost to our health system that may result in long-term costs. When a Canadian experiences kidney failure that requires dialysis, there is a cost. When a Canadian tragically has to undergo amputation, there is a cost. The secondary costs that diabetes has on our public budget cannot be calculated, but every dollar spent preventing it means greater savings down the line. So many of these complications are preventable with the proper care.

When I was first elected in 2015, it was a goal of mine to bring the issues of Canadians living with diabetes to Ottawa and to elevate the issue of diabetes as a whole. I have been honoured to serve as the chair of the all-party diabetes caucus, where we have heard from diabetes advocates, stakeholders and organizations to gain a better understanding of how the federal government can support Canadians living with diabetes.

In 2017, I travelled extensively to consult with medical professionals and stakeholders about how best to meet the needs of those suffering from diabetes. This gave me even greater insight into how diabetes impacted communities in different regions of Canada. The result of this was the publication of the report, “Defeating Diabetes”, which promotes healthy eating as a prevention method.

That same year, I represented Canada at the Global Diabetes Policy Summit in Rome, Italy, where 38 countries were represented. We spoke about the best way to tackle this growing issue. I also attended the World Congress of Diabetes in Calcutta, where, through engagement with international leaders, we were able to compare research and assess our commitment to the fight against diabetes.

One other important aspect of diabetes I learned on these international travels was how well-respected Canada is on the world stage when it comes to diabetes, especially on the insulin invention. I hope that Canada will continue to be a global leader in the fight to defeat diabetes for years to come.

Locally, I successfully advocated for the City of Brampton to proclaim November as Diabetes Awareness Month and the 14th as Diabetes Day. In 2018, the all-party diabetes caucus engaged fellow parliamentarians to participate in Diabetes Day on the Hill to raise awareness of diabetic risks to Canadians and to build support for an updated comprehensive national diabetes strategy. Our diabetes mobile screening unit was brought in to emphasize prevention and encourage testing. This was an opportunity for all members of Parliament to get first-hand experience in understanding the aspects of diabetes. Nearly a hundred of us accepted the challenge to wear a step counter and log our efforts for 10 days to raise awareness around our health.

This spring, I was able to virtually participate in several meetings and town halls with Diabetes Canada about how Canadians living with diabetes have been affected by COVID-19. While people with diabetes are not more likely to catch COVID-19, if they do get it, adults living with diabetes are at greater risk of developing serious symptoms and complications. More recent data from Alberta shows that 42% of Albertans who have died of COVID-19 also had diabetes. Those who are infected with the virus are more likely to suffer serious cardiac and respiratory complications. They face mortality four times that of those without diabetes.

As many members of the House know, back in the spring of 2019 I was proud to bring forward the unanimously supported motion to declare November as Diabetes Awareness Month in Canada, but there is so much more to do than raise awareness. The World Health Organization recommends that every country implement a national framework for diabetes. Last April, the Standing Committee on Health tabled a report that gave multiple recommendations. Among them the committee asked that the government consider a framework for a diabetes strategy for Canada. This comprehensive report already outlined the steps that the government should take in the fight against diabetes.

When we were undergoing this study, we heard a great deal about the mental health issues that are common among people living with diabetes. Those living with type 2 diabetes are more at risk of depression. We have heard examples of their being stigmatized and bullied. There are overall signs of greater risk of mental health issues, including anxiety and depression. At the health committee, we heard from one individual living with diabetes who spoke openly about the anxiety and the stigma she felt around the disease in her family. She said:

In my family, there are 35 diabetics and we don't talk about it. I have to do my blood sugar under the table when I visit my mother. We don't discuss it, and they don't treat.

Last year, I lost my uncle to it because they just won't treat. They won't admit to it. They don't want to deal with it because the stigma is so bad.

There is a strong need to reduce the stigma associated with diabetes. Reducing messaging that blames patients for their diabetes is an important first step to take. Early detection of diabetes can prevent complications and reduce the strain on the health care system.

The health committee also heard some shocking stats about diabetes and indigenous communities. Diabetes rates are three to four times higher among first nations than among the general Canadian population, and many indigenous people are at increased risk of developing diabetes. Furthermore, indigenous individuals are diagnosed with type 2 diabetes at a younger age than other individuals. Those living in a first nation community who are in their twenties have an 80% chance of developing the disease during their lifetimes, compared with 50% among the rest of the population of the same age.

The Canadian Indigenous Nurses Association identified several factors as to why this is the case. Geographical isolation, lack of health care services, poor Internet connectivity to facilitate distance care, and reduced access to nutritious food all contribute to the prevalence of diabetes in indigenous communities.

The health committee also recommended the federal government hold discussions with the provinces to explore possible approaches to providing uniform coverage of diabetes-related medications, supplies and equipment, such as lancets, across Canada. As it stands now, each province provides different coverage for different aspects of diabetes treatment, meaning those living with diabetes receive uneven support depending on where they live. All levels of government must work together to find a solution to improve access to a family physician and other health services for people living with diabetes in rural, remote and northern communities.

As I mentioned previously, my community in Brampton and the Peel Region faces a high rate of diabetes compared with the rest of the country. However, locally, we have some true diabetes champions working to reverse this course. I appreciate all of the private sector stakeholders based in Brampton that do phenomenal work helping those with diabetes, such as Medtronic and Dynacare, which provide testing services and advice to help people manage their illness.

The #Dynacare4Diabetes wellness campaign just launched in our city. The goal of this campaign is to encourage Bramptonians to assess their risk and get tested to see if they are at risk of diabetes by providing the A1 test free of charge.

Medtronic is doing commendable work in providing compassionate care for our residents living with diabetes.

I would like to thank Laura Syron, the president of Diabetes Canada, and its federal affairs director, Kimberley Hanson. I have been proud to work alongside them to raise awareness, including helping them with multilingual communications materials for multicultural communities.

I would also like to thank JDRF, Canada's leading type 1 diabetes advocacy organization, for all the support and advice it has provided over the years. It also endorsed my bill.

I am so proud to have support on this bill from organizations and individuals such as the CNIB Foundation, Peel's medical officer of health, Dr. Lawrence Loh, Dr. Naveed Mohammad of William Osler Health System and many more.

I thank the Brampton City Council, which has officially endorsed this bill.

Canada has repeatedly been the home of some of the biggest breakthroughs in diabetes care and research. Twenty years ago, Dr. Shapiro at the University of Alberta was on the team of researchers that developed the Edmonton protocol and islet transplant procedure, which temporarily reversed diabetes and allowed patients to be insulin independent. Just last week, it was reported that his team may be on its way to finding an actual cure for diabetes. This work is in its early stages.

In 1961, Canadian scientists discovered stem cells, and of course next year will mark the 100th anniversary of Sir Frederick Banting's historic discovery of insulin right here in Canada. Two weeks ago, on World Diabetes Day, I was in London, Ontario to participate in the ceremony to rekindle the Flame of Hope. This flame has been burning brightly and will continue to do so until we find a cure for diabetes. It stands as a symbol of Canadian innovation. I hope it will be a Canadian team of researchers that will one day be able to extinguish this flame.

Bill C-237 would change the lives of the 11 million Canadians living with diabetes from coast to coast to coast. By working together, I am confident that one day we will extinguish the torch at Banting House. Together, I know we will find a way to defeat diabetes.

I encourage all members in the House to join me in supporting the improvement of the lives of millions of Canadians across our country.

Canada gave insulin to the world. There is no reason why we cannot lead the way to defeat diabetes.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Madam Speaker, if I may, I would like to express my appreciation to the mover of the bill. She has been an incredible advocate on the diabetes file. Over the years, I have seen her advocate very passionately here in the House, as well as in caucus and on the side with many people.

Obviously, she is very passionate about the issue. I wanted to give her my personal thanks for being such a strong advocate on such an important health issue that all Canadians need to have a better understanding of.

I wanted to make that comment and compliment my colleague.

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I would like to thank my hon. colleague for his great passion for diabetes. We need diabetes advocates on all sides of the House.

The member is right that the bill is rooted in the community I represent in the Peel region. I am passionate because I know that diabetes is a big burden on the health care system. I have heard from so many constituents who have diabetes or whose family members do, and they need more support. One in six people in Peel is affected by diabetes. This is so—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Questions and comments, the hon. member for Shefford.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker, I thank my colleague from Brampton South for her excellent speech. She and I are both members of the Standing Committee on the Status of Women.

In her speech, she talked a lot about the skyrocketing health care costs associated with diabetes.

How will she ensure that this bill respects the jurisdiction of Quebec and the provinces, say by boosting health transfers to 35%, and that the federal government attends to its own affairs?

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I recognize my colleague's interest in increasing health transfers to the provinces. During the pandemic, the federal government has been there to support the provinces, including with $19 billion in the safe restart program.

The bill follows up the report from the health committee, and the framework includes measures to identify the training needs of health care professionals related to prevention and treatment. It promotes research, data collection and information sharing and takes into consideration existing strategies and best practices, such as those in the committee report, including—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Questions and comments, the hon. member for South Okanagan—West Kootenay.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, I thank the member for the important bill before us. I fully support it.

She has pointed that from the start, Canada has been a world leader in the technology of treating diabetes. However, we are really near the bottom of the pack when it comes to access to treatments, needless hospitalizations and needless deaths. That is because half of the diabetics in Canada cannot afford to pay for their insulin and the devices they use to monitor it.

I am wondering if the member and her Liberal colleagues will be supporting Bill C-213, the NDP bill on a publicly paid universal pharmacare plan, which would solve this problem once and for all.

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I thank the hon. member for supporting the bill.

The bill is important because the framework will include everything for prevention and treatment. I am proud to sit on the Standing Committee on Health, which got the great work done for national pharmacare. Some of that work included the report on the national pharmacare plan. The health committee heard from witnesses that 22% of Canadians are not getting their prescription medications. We need to include our provincial partners and territories as well.

The bill is important because it would help 11 million Canadians living with diabetes or prediabetes. It is one of the most prevalent diseases in the country. As I said, it is a very good bill for helping all 11 million Canadians with diabetes or prediabetes.

[Chris d'Entremont, Conservative, West Nova, NS]

Madam Speaker, I am very pleased to speak today on second reading of Bill C-237, an act to establish a national framework for diabetes, which would require the Minister of Health to develop a national framework to support diabetes prevention and, of course, treatment.

It is important for me to participate in the second reading of this bill given that my family is touched by this disease. My son, André was diagnosed with type 1 diabetes at the age of 17. He, my wife and I had to adapt to his disease and help him understand his new limitations, but celebrate, of course, his strengths.

We were lucky, if that is the right word, in that we came into this at a later age, where André was more than capable of taking over his care and express how he was feeling.

I can only imagine what it would be like with a toddler or a younger child. A friend of mine used to tell me what it was like 30 years ago without modern strip testing, trying to get a ketone reading from her toddler's diaper. How far we have come, considering a lot of diabetics now use continuous testing, where we can just swipe our smart phones near to get a reading. However, we still have a long ways to go.

Due to this disease connection, I am involved with various organizations that support patients with diabetes, such as the JDRF, one of the many organizations that work tirelessly to support people living with diabetes and their families until a cure is finally found.

November is Diabetes Awareness Month. This year, I should add that next year, 2021, will mark the 100th anniversary of the discovery of insulin by Dr. Charles Best and Dr. Frederick Banting.

In Canada, diabetes affects more than three million people, or 8% of the total population, and is considered a national epidemic. When pre-diabetic people, caregivers and families of people with diabetes are considered, this number rises to 11 million Canadians, or about 30% of the total population.

It is important to note that these numbers are increasing year after year. Even if people with diabetes manage to live what they call a normal life, we must continue to work for the prevention of diabetes and its consequences until a cure is found. Since diabetes affects so many people in Canada, we need to be in a better position and have legislation that responds adequately to the needs of people living with diabetes and pre-diabetes with the development of a national framework.

Bill C-237 seeks to respond to diabetes in Canada by improving awareness, prevention, treatment, research, data collection and training. It also wants to follow up on the Canadian diabetes strategy that was created in 1999, which aimed to prevent, detect early and self-manage diabetes and its complications, as well as national surveillance. This has, since 2005, integrated the healthy living and chronic disease strategy to promote the health of all Canadians, reduce the risk of chronic disease related to high-risk individuals, and support detection and early management of chronic diseases.

According to a 2013 report by the Office of the Auditor General, despite numerous efforts to better manage diabetes, the Public Health Agency of Canada, Health Canada and the Canadian Institutes of Health Research believed that, although diabetes prevention and control activities existed, they were not coordinated well enough to ensure the success of the Canadian diabetes strategy.

This report led to studies at the health committee and, following the last study in 2019, a report was tabled. Entitled, “A Diabetes Strategy for Canada“, it strongly recommended that the government proceed with the development of a national strategy on prevention and management of diabetes.

Having spoken with many representatives of various organizations supporting people living with diabetes and those who support research, I know that this bill has been expected for some time now, and I do see it as a positive step forward.

However, I have some concerns with the bill in its current form, which gives the Minister of Health the authority to prepare a report on establishing a national diabetes framework without parliamentarians being made aware. This is concerning, since there will be many financial implications related to the collection of data and the research that the bill will require, which we will not know before voting for it.

It is important to remember that during the first reading of the bill last February, before the beginning of the COVID-19 pandemic, we already knew that the Liberal government had reached record deficits and debts.

We on this side of the House were very much looking forward to the tabling of the Liberal budget in March, which of course never happened. The Liberals' lack of transparency left all Canadians in the dark regarding their country's public finances. It is concerning knowing that two years will have passed before the government finally tables its budget in March 2021.

Government spending has hit record highs. Yes, money had to be spent to fight the pandemic, but we also know that some of that spending was not in Canadians' best interest. Some of it reeks of scandal.

Having said this, despite the good intention of the bill, it is difficult for me to vote in favour of it without knowing all the financial implications that go along with it. I find it unacceptable and irresponsible for the government to continue to lack transparency when it comes to our country's finances.

The establishment of a national framework for diabetes is without a doubt very important, but I wonder about the other diseases that also deserve to benefit from such a national framework. I think of people who suffer from cystic fibrosis, multiple sclerosis or Parkinson's. Which of these diseases also deserve a national framework?

Unfortunately there is a weakness in the bill that I must highlight. As drafted, Bill C-237 does not clearly demonstrate, even though the Minister of Health would be responsible for establishing a framework and implementing it at the national level, who would respond to the problems and expectations, or even how, of diabetics in Canada.

We have to take into account the fact that health programs are essentially the responsibility of the provinces and that approaches to health care vary from one province to the next.

For example, for people with type 1 diabetes, Ontario has the assistive devices program, the ADP, which helps diabetics pay for their insulin pumps, while elsewhere in the country, financial support at the provincial level is less generous or non-existent. Accordingly, a consultation with the provinces and territories is needed.

The Conservatives have always respected provincial jurisdictions and we will always continue to do so. I want to ensure that the bill does not interfere with how each province and territory manages their health care system. The Conservatives have always given priority to working collaboratively with the provinces and territories and we are convinced that this fundamental value of our party would allow us to develop strong national objectives in terms of the quality of the desired framework.

It would be better to adopt a national framework to measurably improve the prevention and treatment of diabetes and thereby reduce the burden of this disease on the Canadian public and the health care system, which is already strained.

As a country that has the health Canadians at heart in all its forms, we should allow Canadians living with type I diabetes to benefit from an equal basis from the disability tax credit as well as those who access the registered disability savings plan, which would be an important and significant step forward. This would be a concrete measure to reduce the amount of expenses incurred by people living with diabetes and would significantly help them improve their health.

In September 2019, the Conservative Party announced that it wanted to broaden the eligibility criteria for the disability tax credit. This announcement was specifically intended for type I diabetics. Diabetes Canada supported it and asked the other parties to support it as well. We believe diabetics should have access to the DTC and call on all federal parties to include it.

As our family lives with it, I support it in a way—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

The member is out of time.

The hon. member for Shefford.

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Speaker I rise today to speak in the House of Commons about Bill C-237, an act to establish a national framework for diabetes, a disease that affects members of my family.

I first heard about this disease when I was a child. I was told that my father's half-sister had diabetes and that she had problems with the sugar levels in her blood. Then, when I was a teenager, a cousin who is my age was diagnosed with this disease. My mother was her godmother, so together with her mother, we supported her during months of treatment at Hôpital Sainte-Justin.

It was a great shock for her because she had to get used to a new diet, pricking herself several times a day and avoiding the complications that can be associated with diabetes. She rebelled because she was tired of having to follow so many rules to control her blood sugar levels.

In recent months, I have been the Bloc Québécois critic for seniors, and naturally I have been dealing with this issue. In my speech, I will remind members of the elements of this bill that my party supports and explain the effects of the pandemic on those with this disease. Finally, I will call for better investments in research, which is the key to a cure.

The enactment provides for the development of a national framework designed to support improved access to diabetes prevention and treatment. It asks that the Parliament of Canada recognize the need to be proactive in the fight against diabetes and that the Government of Canada develop and implement a national framework for diabetes.

The bill provides for the strategy to be designed in consultation with the provincial governments and Quebec. If the bill moves forward, the Bloc Québécois must ensure that the national framework reflects the demands of Quebec and respects its jurisdiction. The bill invites stakeholders to a conference for the purpose of developing a national framework and determining the main focuses that should be included: explanations on diabetes, identification of needs, promotion of research, promotion of knowledge sharing, analysis of what is already being done to achieve health care equality and so forth. The bill gives the government one year to develop the strategic framework and five years to report on its effectiveness.

It is important to note that this disease is on the rise in Canada, and that it entails significant expenses for patients and for the system. On behalf of myself and the Bloc, I would like to take this opportunity to remind everyone that Canadian health transfers must be increased to 35% right away, no strings attached. The same thing is happening in Quebec, where cases have been rising steadily since 2000.

At this point, I would like to go over a brief history of the fight against diabetes in Canada. It began between 1999 and 2005, when the first Canadian diabetes strategy was developed. The Canadian diabetes strategy was launched in 2005, and it was then incorporated into the integrated strategy on healthy living and chronic diseases.

In 2006, the strategy began funding multi-sectoral organizations dedicated to fighting chronic disease. A number of advances came about during that period, including self-management of the disease, thanks to the development of guides for people with diabetes; the dissemination of information about the disease, thanks to data collected by the Public Health Agency of Canada; and the Canadian Best Practices Portal.

In 2009, the Public Health Agency of Canada, Health Canada and the Canadian Institutes of Health Research established a partnership with Diabetes Canada, Diabetes Québec and the Juvenile Diabetes Research Foundation. From then on, funding of research projects and public awareness were part of the fight against diabetes.

Since 2016, the Canadian diabetes strategy has been part of Health Canada's Centre for Chronic Disease Prevention and the strategic plan 2016-2019. This plan is very general and contains more statements of principle than meaningful measures. The main elements are practically the same as in previous plans: support research, collect and share data and mobilize various stakeholders.

Since 2019, Diabetes Canada has been promoting Diabetes 360^o, a framework calling on the federal government to create and fund a national strategy.

Although health care is a provincial jurisdiction, the federal government must play a role, especially when it comes to prevention. Because obesity and diabetes are so closely linked, governments must develop strategies to promote awareness and healthy living habits. Over time, several measures have been designed to do just that. I will give an overview.

With regard to labelling, although there have been many changes in this area, the government systematically runs into problems with lobby groups representing beverage companies and producers, for instance. This idea comes up regularly in discussions. The objective would be to change labels to make them easier for consumers to read or to make space on soft drink labels to inform the public about the harmful effects of obesity.

The government also promotes physical activity, which we care a lot about. Ongoing measures include awareness campaigns, the promotion of physical activity and tax credits for sports activities.

In addition, the government promotes healthy eating, or maintaining a healthy body weight. That is an important part of preventing and controlling diabetes.

Although it is sometimes difficult to strike a balance between economic interests and promoting healthy eating, as the debate surrounding Canada's food guide showed, the public still needs to be informed and needs to develop healthy eating habits.

I would now like to talk briefly about diabetes among indigenous people. For many reasons, the prevalence of type 2 diabetes is four to five times higher in certain indigenous communities than in the general population.

The Government of Canada is aware of the problem and is investing an average of $50 million per year through the aboriginal diabetes initiative, a Health Canada program that involves working with indigenous people to reduce health inequalities.

For indigenous communities, there are three components to the fight against diabetes. First, there is prevention, in the form of awareness campaigns on healthy lifestyle habits that can prevent obesity and the risks related to diabetes. Then there are annual screening tests for high-risk individuals, so they can be treated as soon as possible and avoid complications. Finally, there is treatment, which ensures that people from indigenous communities who have diabetes get treated in accordance with the guidelines, in order to reduce morbidity and mortality.

As for the cause, or should I say causes, of this major disparity, might the government's inaction to improve the situation on indigenous reserves have something to do with it? The answer is in the question. An ounce of prevention is worth a pound of cure.

Third, I would like to remind hon. members of the consequences that the pandemic is having on diabetics. Given their condition, they are being asked to self-isolate to avoid COVID-19 and the resulting complications. They are also experiencing economic repercussions.

I would like to note that back home in Shefford, the diabetes health forum, which had been organized by Les Diabétiques de la Haute-Yamaska to raise awareness of this disease, unfortunately had to be cancelled last March.

However, over Zoom, I was able to meet with Juliette, from the Kids for a Cure Lobby Day organized by JDRF. I salute her for her courage. She and her organization made three recommendations.

The first recommendation is that the Government of Canada should mark the 100th anniversary of the discovery of insulin by making a new $15-million investment in partnerships to cure diabetes between JDRF and the Canadian Institutes of Health Research.

The second recommendation is that, as recommended in the first annual report of the disability advisory committee, Canadians who receive a life-sustaining therapy, such as insulin therapy, should be eligible for the disability tax credit.

The third recommendation is that, as recommended by the Standing Committee on Health in its report entitled “A Diabetes Strategy for Canada”, the Government of Canada should invest in the implementation of a national diabetes strategy, Diabetes 360^o, designed to achieve different results depending on the type of diabetes.

We are therefore in favour of the development of a strategy for Canada, on condition that it respects the requests of the provinces and Quebec and areas of shared jurisdiction. It should be noted that Diabetes Canada and Diabetes Québec already hold an annual conference. We are wondering what this additional conference might be and what benefit it could have on the community.

In closing, for all these reasons, I decided to accept the invitation and light up my office with beautiful blue lights as a sign of solidarity on World Diabetes Day, which was November 14. Let us take action.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, these days the world is focused on a pandemic, but that does not mean we have to forget about the myriad of other illnesses suffered by humanity. That is why I am happy to voice my support for Bill C-237, which would require the Minister of Health to develop a national framework for diabetes prevention and treatment in consultation with the provinces, indigenous groups and relevant stakeholders.

I support the bill because I believe we truly need a new national diabetes strategy. That strategy should be based on the diabetes 360° framework developed in 2018 by Diabetes Canada and dozens of other stakeholder groups. I also believe that the Government of Canada must support indigenous-led diabetes programs, services and research; prioritize food sovereignty; provide access to appropriate care and treatment options; and raise awareness about gestational diabetes and the increase in diabetes among young indigenous women.

I also strongly believe that there is an urgent need for a national approach to pharmacare that would ensure all Canadians living with diabetes have access to the medications they need when they need them. This must include coverage for diabetes devices and supplies, such as test strips, syringes, insulin pumps and continuous glucose monitors.

We all know the story of Frederick Banting and Charles Best, who, with their colleagues James Collip and John Macleod, discovered insulin in a University of Toronto lab in 1921. This discovery revolutionized the treatment of diabetes worldwide and remains among the most celebrated medical discoveries in Canadian and even world history. Diabetes was formerly a death sentence for young people who developed the disease, but now they could look forward to long and productive lives.

We are on the eve of the centenary of that discovery, and one would think that we could celebrate that centenary with pride. Unfortunately, the scourge of diabetes is, in many ways, far worse than it was 100 years ago. Canada has one of the poorest records in the world, and it is getting worse.

Every three minutes a Canadian is diagnosed with diabetes. The number of Canadians with diabetes has doubled in the last 20 years. Right now, one in three Canadians either have diabetes or have a high risk of developing it. It is an epidemic. People who are 20 years old in Canada have a 50% chance of developing diabetes in their lifetime. For first nations people, that risk is 80%.

The health care costs of diabetes will top $40 billion by 2029. Diabetes causes 30% of strokes, and it is the leading cause of blindness. It causes 40% of heart attacks, 50% of cases of kidney failure, and 70% of leg and foot amputations. It reduces lifespans by five to 15 years, and about 7,000 Canadians die each year as a direct result of diabetes.

Thankfully, there is a plan for how to fight this scourge. Diabetes Canada has developed a detailed plan called diabetes 360°, which could dramatically improve our rate of diabetes and reduce the significant impacts it has on the health of Canadians. It will cost money, but that investment will repay itself a hundred times over in savings to our health care system.

The goal of diabetes 360° is to have 90% of Canadians living in an environment that preserves wellness and prevents the development of diabetes, 90% of Canadians aware of their diabetes status, 90% of Canadians living with diabetes engaged in appropriate interventions, and 90% of Canadians engaged in interventions achieving improved health conditions. Diabetes 360° must be the basis for any national strategy.

When Dr. Banting discovered insulin, he gave the rights to that discovery to the University of Toronto, so that diabetics around the world could have affordable access to this life-saving drug. However, times have changed, and many of the monitoring and injection devices are very expensive. Many Canadians living with diabetes are unable to afford the medications, devices and supplies they need.

This cost related non-adherence can lead to avoidable complications and mortality, and that is why there is an urgent need for a universal, comprehensive and public pharmacare plan to ensure all Canadians have access to the medications they need when they need them. As I mentioned, this must include coverage for devices, such as test strips, syringes, insulin pumps and continuous glucose monitors.

The Canadian Federation of Nurses Unions produced a report that found that 57%, over half, of diabetics in Canada reported failing to adhere to their prescribed therapies due to affordability issues related to those medications.

According to the Juvenile Diabetes Research Foundation Canada, 830 young and middle-aged diabetics in Ontario die each year because of poor access to insulin. That could dramatically change if all Canadians had access to the medicines they need, but they do not.

Canada is the only country with a universal health care plan that does not include free access to prescribed medications. Some 10% to 20% of Canadians report not filling their prescriptions because they simply cannot afford the cost. That non-adherence costs all of us in added hospital stays and extra pressure on our health care system.

A universal, single-payer public pharmacare plan would save over $4 billion per year because we could get better deals on our drug costs. Right now, we pay more for drugs than almost any other country in the world.

All Canadians would benefit from a public pharmacare system, but diabetics would benefit more than most, because they would be assured of access to insulin and the monitoring equipment they need to manage their disease to stay alive.

Canada should be proud of its history in the treatment of diabetes and the discovery of insulin, but right now, we are at the bottom of the list when it comes to treatment, hospitalizations and needless deaths. We need to turn this trend around.

Bill C-237 would go a long way to achieve this turnaround by mandating the creation of a national framework. However, for rapid and lasting success we need real government leadership and investment in community health programs and public pharmacare to make a real difference in the health of Canadians.

I call on all members here to support Bill C-237, and even more importantly, Bill C-213, the bill calling for a universal, publicly funded pharmacare program tabled by my colleague the member for New Westminster—Burnaby. That program would save billions of dollars in public expenditure and most of all, would save thousands of lives of people, young and old, who suffer from diabetes and other ailments across the country.

[Ruby Sahota, Liberal, Brampton North, ON]

Madam Speaker, it is an honour to rise today to support my colleague from Brampton South on her private member's bill, Bill C-237, an act to establish a national framework for diabetes. She has done incredible work on the issue of diabetes and my fellow Brampton colleagues and I fully support and endorse her work.

This is a critical issue for the residents in my constituency, and had I been selected in the private member's lottery process, it is something I would have loved to bring forward myself. Therefore, I am extremely pleased to see the bill before the House at second reading.

The issue of diabetes is very near and dear to my heart. I make it a point to meet with JDRF's Kids for a Cure each year to listen to their suggestions and to advocate for what the Government of Canada can do better to help.

I have seen the issue first-hand, as my childhood best friend suffered from type 1 diabetes. Throughout his childhood, he had many struggles, and I could not understand at the time why he had to take them on. Into his adult years, many more obstacles faced him. This story did not end well: We lost him all too soon a few years back because of complications from this terrible disease.

My maternal grandmother also passed because of complications from diabetes, and my mother suffers from type 2 diabetes. Thus, I am predisposed to becoming the next victim of this terrible disease. I already had gestational diabetes during my pregnancy with my son, something I find very hard to talk about since I feel there is a stigma attached to having diabetes. People feel it is somehow their fault. As a mother, I know mothers do not want to do anything to affect the health and well-being of their children.

Canada has accomplished many incredible things in the medical field, and by far our most successful is the discovery of insulin. This breakthrough was a tremendous step forward in diabetes treatment and helping to improve the quality of life of diabetics in Canada and around the world. As we get closer to the 100-year anniversary of its discovery, Canada should once again choose to be a leader in diabetes treatment and invest more in research and countermeasures to help keep our cities stronger and healthier.

Over one million people living in Ontario suffer from type 2 diabetes. The GTA alone has half of Ontario's cases, with my home city of Brampton being known as the diabetes capital of Canada. Brampton has one of the highest rates of diabetes in Ontario, with the exception of only select indigenous communities, where as many as one-third of residents suffer from this terrible disease.

It is my hope that the House will support the bill and support the call for a national framework for diabetes on behalf of my constituents of Brampton North and everyone affected by this disease.

In the last 12 years, the prevalence of diabetes in Ontario has doubled, which to most people means suffering with the disease itself and a list of complications, such as increased heart attacks, strokes, requiring dialysis and undergoing amputations. Diabetes can affect every aspect of a person's life and makes day-to-day activities more challenging. Brampton must deal with all of these complications with only one fully functional hospital and suffers from underfunding of health care from the province as compared with other cities in the province of Ontario.

It is unfortunate, but I have been witnessing my own mother's struggles with this disease for many years now, and as she suffered a heart attack recently, I know how serious the complications can become. My husband, who is a podiatrist, shares many stories of patients who must undergo amputations. I never knew how common amputations due to diabetes were.

What is even more concerning is that despite well-tested methods of prevention and management, diabetes is becoming increasingly more common in Canadian society. New data from the 2019 Diabetes Canada cost model finds that currently one-third of Canadians have either diabetes or pre-diabetes. Worse still, it found that less than 50% of all Canadians can identify less than half of the early warning signs of diabetes, and even less were able to list the health complications diabetes can cause.

This is a worrying trend, which highlights the urgency for creating a strategy to help combat the disease. The need for proper educational tools to teach people about the disease, its causes, symptoms and treatments is absolutely clear. If we can push through the right policies and programs, we can reduce the prevalence of diabetes in our communities and keep higher-risk individuals healthy. Canada needs a national framework for diabetes and it needs one now.

Here are the facts. We already know the risk factors that increase the likelihood of developing diabetes.

Obesity, spurred on by unhealthy eating habits and a sedentary lifestyle, plays a significant part in diabetes onset. The likelihood for developing diabetes is more than seven times higher among obese individuals and three times higher among overweight individuals, as determined by a person's BMI.

We also know that socio-economic factors play a big part in the lived experience of having diabetes. Individuals with lower incomes are more likely to suffer complications from the disease and are less likely to regularly see their doctors, compared to those with higher incomes.

We know that pregnant women with diabetes are more likely to have suffered a number of complications with their pregnancies, such as high blood pressure or obstructed births and stillbirths. More pregnant women should be making use of specialist prenatal and obstetrical care, but do not know. There is not enough research and I do not know why.

We also know that ethnic background plays a role, which we just cannot ignore, in determining which communities are more likely to develop this disease. Diabetes is more common in certain ethnic groups, including people of indigenous, South Asian, African and Hispanic descent. When we look at patterns of diabetes in Ontario, the data fit with where these higher-risk communities live.

The GTA and particularly Brampton have high rates of ethnic diversity and we are also seeing higher rates of diabetes. This genetic susceptibility increases the risk of diabetes onset, even for those at a younger age and at lower BMIs, meaning one could be a skinny diabetic. Making the need for community-tailored educational campaigns is that much more important. People might be at higher risk and never even know it, let alone know what steps to take to mitigate these risks.

I would like to take a moment to recognize the great work done by a local community advocate Dr. Bajaj and the Stop Diabetes Foundation. The organization has taken on two main objectives: one, to decrease the burden of diabetes afflicting our society, through community-based education on preventative lifestyle; and, two, to increase the longevity of patients living with diabetes, by using a combination of medically proven treatments and lifestyle regimen.

Education and awareness must be done with social and cultural context taken into consideration. By keeping the status quo and not investing in creating a national framework, we are allowing incident rates to rise for a disease that is proven to be preventable in certain circumstances with the proper educational campaigns, tools and policies.

The bill has many recommendations. Experts suggest that helping to address educational gaps could prevent diabetes onset. Passing the bill will help promote information and knowledge sharing in relation to diabetes prevention and treatment, which is absolutely vital. We can teach people how to create healthier lifestyles through balanced diets and exercise, and explain how these changes will decrease their risk for diabetes.

These educational campaigns can and should be tailored for each region and for specific cultural groups to address our most vulnerable communities that are most at risk due to genetic predispositions. We need to give people the tools to better understand and manage their own health so they can become more proactive in diabetes prevention.

The bill also specifically calls for promoting research and improving data collection on diabetes prevention and treatment when it comes to information gaps. The necessity for filling them is clear. Determining why some pregnant women with diabetes are not receiving special prenatal and obstetrical care is vital to ensuring they have access to these resources.

We also need more reliable information about the availability of—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

I have to interrupt the hon. member as time is up.

Resuming debate, the hon. Parliamentary Secretary to the Leader of the Government in the House of Commons for two and a half minutes.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Madam Speaker, it is quite the privilege to be able to stand in the House and make mention, at least in brief for now, of some thoughts on the bill before us.

First, I want to thank the member for Brampton North for sharing her personal story. I always find it helpful when members of Parliament share stories, and that we relate better. I appreciate it very much.

The member for Brampton South, whom I had the opportunity to ask a question of earlier, is the member who has brought the legislation before us. I would like to again reaffirm that the member for Brampton South has inspired so many individuals with her passion on this particular issue. I do want to thank her for that.

It is estimated that, of Canada's population of about 37 million, three million have some form of diabetes or another. Every year more than 10,000 Canadians will be diagnosed with diabetes. There is absolutely no doubt that we, as a nation, need to look at ways in which we can better deal with treatment-related issues and how we can better prevent it.

There is a role for the national government. I have said in the past, as a former health critic at a provincial level, I understand the importance of provinces and territories working with the national government.

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

The time provided for consideration of private members' business has now expired, and the order is dropped to the bottom of the order of precedence on the Order Paper.

It being 2:30 p.m., the House stands adjourned until next Monday at 11 a.m. pursuant to Standing Order 24(1).

(The House adjourned at 2:30 p.m.)

The House resumed from November 27, 2020, consideration of the motion that Bill C-237, An Act to establish a national framework for diabetes, be read the second time and referred to a committee.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons]

Mr. Speaker, it is a pleasure to address the House of Commons this morning. It is a beautiful sunny day here in Winnipeg. Quite frankly, I would not want to be anywhere else.

Bill C-237 is an important piece of legislation. I want to recognize the member for Brampton South, who has put such a spirited effort into this bill in the previous legislature. There is absolutely no doubt whatsoever in my mind that her heart and mind are with this issue. I have heard her speak to it on several occasions, both inside and outside of the House of Commons. She is one of the most persistent and tenacious ladies I know, and she is trying to address a critically important issue in health care, no matter what province or territory one lives in.

As a former health critic who tries to understand the issues of health care in a broader sense, I can say that diabetes needs a lot more attention. We need to see different levels of government working together, not just the federal government working with the provinces and territories. We need to incorporate indigenous community leaders to be able to deal with even municipal levels of governments. Our school trustees, school divisions and education are so vitally important to the issue of diabetes.

The bill, although it is not complicated, if passed, would have a profound and positive impact on all Canadians in all regions of our country. We are not talking about dozens, thousands, or even hundreds of thousands, but millions of Canadians who are impacted directly by diabetes, not to mention the indirect impacts on families and friends. Suffice it to say that this disease affects all of us directly or indirectly in one way or another.

The costs of ignoring the issue of diabetes is astronomical because it can lead to heart disease, stroke, kidney disease, eye issues, dental disease, and diseases related to nerves, legs and feet. From a personal point of view, one of the first real experiences I had regarding the severity of diabetes was when a good friend of mine had his leg amputated, which came as a bit of a shock to me. More of a shock was when, a couple of years later, he passed away. From what I understand, this was attributed to diabetes.

This is life-saving and the impact it could have is profound. That is why it is important that all members of the House recognize the true value of Bill C-237. I assure the member for Brampton South that I will be supporting this important piece of legislation. I would be shocked and disappointed if any members of the House did not support it.

In essence, the bill is asking for the design and development of a national framework to support improved access for all Canadians to diabetes prevention and treatment. How could one not support that? If we truly understand the issues of health care and look at the mobility of people today, it is a no-brainer that we need this type of legislation to move us forward.

There are even some time frames within the legislation for when it is passed and receives royal assent. Twelve months after coming into force, there would be a report setting out that national framework, which would be prepared and ultimately presented to Parliament. There is a sense of accountability from the Minister of Health, and a time frame for when the minister must report on the effectiveness of that strategy.

I believe these things would have a very strong impact on all of our communities. This one of the reasons this is something we should get behind.

Establishing a national framework would provide the Government of Canada the opportunity to work closely with many different diabetes stakeholders. There are some fantastic groups out there. I suspect one only needs to talk to the member for Brampton South, who could cite some of the stakeholders, individuals and constituents she has met with to address this particular issue.

Often when I make reference to stakeholders, I make reference to the different levels of government. We have some very strong advocates with the Canadian Diabetes Association, and many other organizations, which support people and advocate on this particular disease.

We need to be bringing those organizations together, and bringing in the different levels of government, including indigenous communities, as I consider them a level of government equal to the national government, to have that important dialogue on diabetes and understand the very basics. Back in the mid-1990s, general education on diabetes was in great need. Even with Google today, the need is still there.

We need to see this legislation passed. I look forward to it going to committee and hopefully getting through the House.

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I am pleased to continue debate on Bill C-237, which was brought forward by the member for Brampton South, and to listen to the previous member. I agree with him. I do not see much to disagree with in this private member's bill. It was in the format of a motion in the previous Parliament, and I know the member for Brampton South is well-meaning in the work she is attempting to have the House pass to committee to study this issue.

The contents create more reports to Parliament and parliamentarians in which we would get further information, hopefully from government sources, that will track and provide very specific timetables and details in the content of this report, which I am all for.

Generally speaking, we find that in government legislation there is simply an ask for a report to be made to Parliament, but often it does not ask for much detail. This one does. It has five points that would be in the report, including an explanation of diabetes and pre-diabetes. It also asks for things like data on the promotion of research, prevention and treatment. There are a lot of good things this bill is attempting to do.

It could have also asked the Canada Revenue Agency to provide more information on the disability tax credit, which we know many diabetics would like to use. In 2017 or 2018 the Liberal government made changes and thousands with type 2 diabetes were no longer able to obtain the DTC.

We also know that the DTC and the registered disability savings plan are two very important programs that a lot of people with serious disabilities make use of, and the DTC maximum payable tax benefit in 2019 was $8,416. This is a substantial amount of money to help people with a disability. For constituents with type 1 and type 2 diabetes, it is a very serious disability.

A mom came to one of my town halls, and at a later point to an annual general meetings in my local association, and she explained how difficult it is to live with a daughter who has diabetes. It involves waking up in the middle of the night because an alarm would go off on the diabetic pump. It is trying to ensure that they have enough insulin, especially after eating.

It is a serious condition, but I do not think many Canadians really understand the depth of how bad it can go. The member for Winnipeg North spoke to how serious this condition can be because of the complications that arise from being a diabetic, and of one of his friends having had a leg amputated.

I have a friend who was diagnosed later in life, and he had half of his foot amputated because of diabetes, so we know it is a very serious condition. Diabetes Canada and JDRF have done extensive, profound work to try to sensitize Canadians and governments across Canada to how serious this condition is, but also to the weight it places on our health care systems. It is one of the fastest rising chronic conditions in our health care system, and it is a big driver of Canadian health care costs.

If we look at Diabetes 360°, I think Diabetes Canada has put forward an excellent plan within it. This framework could be used to further those types of private sector projects that are trying to gather more support, both from government and from private sources. This funding is to ensure that we deal with the rising tide of diabetes diagnoses across our country.

There is a Yiddish proverb that says, “Spare us what we can learn to endure”. Diabetes is a difficult condition to endure. I have kids who have a chronic kidney condition, so I have an inkling of what goes into trying to manage a condition like this. A framework to Parliament is a simple ask by the member from the back benches in this Parliament for the government to build information and report it back to Parliament, so we can have good, solid evidence for decisions to be made in the future.

The disability tax credit is one of the key tools being used by those with a disability across Canada. Members will know I proposed Bill C-399 in the last Parliament. It never came to a vote because I drew too high a ballot count. It would have made changes to the DTC specific to diabetics. This is where it ties in with the national framework that the member is asking the House to pass to committee.

Making it easier to access the disability tax credit, or any type of disability program that the federal government could run, should be addressed directly in the framework. I would hope that the reports provided to Parliament in the future would specifically address the disability tax credit, how it functions, and how it addresses issues and conditions such as diabetes.

An important piece of evidence to be tracked is the cost per person, across all of Canada's health care systems, of a diabetic's condition as it worsens in later years. Its annual cost to the health care system would lead to better decision-making at the front end when considering different types of insulin and technology, and whether there is a government role or support that could be provided to bridge the gap for those who cannot afford it.

One of the recommendations in the pre-budget report from the finance committee in this Parliament was to make the disability tax credit refundable. Because tax credits are administered by the Canada Revenue Agency, those types of decisions would be easier to make if a national framework, and a report from a national framework specifically on diabetes, provided information and evidence from the DTC program on the top 10 doctors in Canada who are approving the six-page form for the DTC, and if they are approving them specifically for diabetes. That would offer an excellent opportunity for parliamentarians to reach out to those doctors and ask them to describe their experience filling out these applications, how serious the condition is, what the downside is and what it can lead to. That would be an interesting data point, and we cannot easily get that information without having something like a national framework that produces evidence.

As I said, I would like to see the Canada Revenue Agency compelled, through a report tabled in Parliament through this national framework, to provide such information. I would also like to see which provinces are applying the most for this one condition, specifically diabetes. JDRF, Diabetes Canada and other stakeholder groups have all asked in the past for more information to be provided to us so that we could make better decisions.

Often, I find that the Canada Revenue Agency is a black box: It does not like to reveal any type of information. A few years ago, the Auditor General reported on the DTC and the program's performance and administration. It was not very good. It was not what we parliamentarians would expect to see in the administration of such an important tax credit for Canadians.

A report like this is important. It is beneficial. I applaud the member for bringing it forward. I have no doubt that we will be able to pass it to committee, and I am hoping at that stage there would be further consideration given to perhaps including a specific mention of the disability tax credit and other federal government programs specific to diabetics, and that we could address the specific lack of information in the framework. When the bill returns to the House and we have our final say before it heads to the Senate, we could add that important piece of information. The changes that were made a few years ago by the Canada Revenue Agency, as directed by the government, really hurt the case for thousands of diabetics across the country who were removed from the disability tax credit. It would be good for us all to have that type of information available.

I will be voting for this private member's bill. It is a good bill. It provides the foundations for better work to be done at committee to add the disability tax credit angle. Again, spare us not what we can endure to learn. Diabetes is a very serious chronic medical condition, and it is about time we had a framework in this country to deal with it.

[Sébastien Lemire, Bloc, Abitibi—Témiscamingue, QC]

Madam Speaker, it is important for me to speak to this issue this morning. I thank the member for Brampton South for giving us the opportunity to do so.

Unfortunately, despite the many efforts that have been made to combat diabetes in Quebec and Canada, this chronic disease continues to progress. The percentage of people with diabetes continues to grow. Nearly 8% of Canadians have either type 1 or type 2 diabetes. More than 888,000 Quebeckers and 4 million Canadians have diabetes.

Today, the treatment and management of this disease and its impacts impose a financial burden estimated at $3 billion a year in direct and indirect costs. Diabetics require a range of health care services, mainly to treat and manage the disease but also to diagnose and treat related complications.

The direct costs are those associated with the health care services covered by public or private health insurance or by the individuals and their families. The indirect costs are those that are not related to health care and have an impact on the economy and individuals when a loss of productivity arises as a result of the disease, a disability or premature death.

Canada has a long history of fighting diabetes. In 1999, 4% of the population had diabetes, and that number has doubled in the past 20 years. Grabbing the bull by the horns, the authorities created Canada's first diabetes strategies, which involved collecting and sharing information and mobilizing stakeholders. Ten years later, in 2009, efforts to fight diabetes were augmented by funding for research and public awareness. Since 2019, organizations have been calling on the Government of Canada to set up a strategic framework and fund a national strategy. That brings us to today. Bill C-237 would create a Canadian national framework for diabetes.

What is a national framework? Its goal would be to improve access to diabetes prevention and treatment. That is a good thing. We have to act fast because the incidence of diabetes is rising at an alarming rate. I would point out that the purpose of Bill C-237 is to have Canada's Parliament recognize the need to be proactive in the fight against diabetes and to have the Government of Canada develop and implement a national diabetes framework.

The bill provides for the strategy to be designed in consultation with the provincial governments and Quebec. Organizations, provincial governments and the federal government must work together to develop this national framework and determine the broad themes to be included, such as education about diabetes, identification of needs, promotion of research, promotion of knowledge sharing and analyses of what is already being done to achieve health care equality.

The bill gives the government one year to develop the strategic framework and five years to report on its effectiveness. This is all well and good. The Bloc Québécois supports Bill C-237 as long as the Canadian national framework does not infringe on Quebec's jurisdiction over health care. Before the bill can move forward, the Bloc Québécois must ensure that the Canadian national framework reflects the demands of Quebec and respects its jurisdiction. As far as Quebec is concerned, the federal government should only be involved in the areas of prevention and research.

I want to acknowledge the efforts of the hon. member for Brampton South. I would like to highlight what our colleague has done in the fight against diabetes. She worked in the health sector for 15 years and devoted part of her career to the cause of diabetes, since it is very important to her. She took part in the Diabetes Canada 2018 forum. She has also moved three motions on diabetes to raise public awareness. She wrote a report entitled “Defeating Diabetes”. It presented a cross section of the various stakeholders that are likely to make an impact on the issue. We at the Bloc Québécois believe that her desire to contribute to the cause is sincere and that, at the very least, she knows what she is talking about.

More than ever, we must fund research. The way we beat diabetes is by ensuring better prevention and making discoveries that will lead to a cure. We must give more funding to research so we can contribute to the global effort on diabetes research. This research is making progress on many fronts. The latest advances include improved methods for insulin delivery and control of blood sugar, as well as better insulin pumps. The most significant breakthrough in all this is the transplantation of insulin-producing cells.

A number of researchers are working on transforming stem cells into healthy beta cells that can be transplanted into patients. We can now manage insulin-producing cells that act like the beta cells we have in the pancreas.

These are promising advances, but we cannot overlook any aspects of diabetes. Research is needed so that we can learn more about the mechanism of diabetes and expand our knowledge in such areas as pharmaceutical research, diabetes screening, food, weight issues and physical activity programs tailored to people with diabetes.

Let us talk about the close relationship between obesity and diabetes. The governments of Quebec and Canada have developed strategies to promote healthy lifestyles among Quebeckers and Canadians. Governments must continue to promote awareness, which is not easy to do, since big multinationals bombard us with advertising and sell us high-calorie foods that can cause obesity and, as a result, diabetes.

Governments must continue promoting physical activity through awareness campaigns but also through enhanced tax credits for sports. The rise of type 2 diabetes among young children is alarming, so we need to get kids moving. Governments also have to continue promoting healthy eating and a healthy weight. They must also provide financial support to organizations like Diabète Québec and Diabetes Canada.

I would be remiss if I did not remind the federal government that it needs to provide more help for Quebeckers and Canadians, and in particular indigenous communities, which have much higher rates of diabetes than the general population.

I want to throw out a question about COVID-19 vaccinations for us to think about. Should people with chronic diseases like diabetes get priority for the COVID-19 vaccine?

For all of these reasons, the Bloc Québécois is in favour of developing a strategy, provided that it respects the provinces' demands and the division of powers.

I would also like to point out the work being done by local and regional stakeholders. I especially want to acknowledge the work of my friend, Anne-Marie Trépanier, who has had type 1 diabetes since forever. Many people are battling diabetes and must develop a different lifestyle. We must be there for them because, from what I have understood by talking with my friend, they require a significant amount of psychological and physical support. Associations play a fundamental role in these areas. In terms of awareness of this disease, we must also think of local associations, which offer essential services.

I will conclude by mentioning that this disease can strike anyone at any time. There is a strong link between cardiovascular disease and diabetes. My father passed away 10 years ago, and in his final days we suspected that diabetes was involved. Diabetes probably accelerated his failing health and contributed to his heart attack.

It is important to invest in research, especially in diabetes management, which could have given my father better health in his final days and extended his life so that he might have been able to enjoy his grandchildren for a few more years.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Resuming debate, the hon. member for Windsor West. I will take this moment to wish him and his wife a happy anniversary.

[Brian Masse, NDP, Windsor West, ON]

Madam Speaker, that is very gracious of you. I appreciate it, because it is a special day. I want to thank Terry for 24 years of putting up with this. I will take these glasses off because they will fog up as I talk in the debate today.

It is a great debate. It is something that I think the House will support, but it is also something that I am hoping, after my 18 years here in the chamber, will actually get some action. How many times do we have to talk about diabetes and issues like it and not have any real action. Why are we waiting? What will change between now and 10 years from now? Nothing. We know diabetes has a significant consequence on our population. We know it has a significant consequence on our economy and a significant consequence on what we do every single day, yet we still do not have a national strategy. We have not supported it through either a provincial or a federal plan.

I do not see this as a jurisdictional issue, whether it be Quebec, British Columbia, Ontario, Saskatchewan or Newfoundland. I see it as an issue that kind of brought me to politics. As an employment specialist for persons with disabilities and as a PSW, I met people with diabetes who had extra complications in their lives. Why we would not provide the support for medications and proactive engagement in their treatment is beyond me as a legislator in this House and in this chamber. Having discussions and spending time on this issue is kind of incomprehensible in many respects. We know that if we actually do the right things, we can support people. The modest things that are necessary would give them extra life, extra employment, inclusion and, most importantly, the sense of fulfillment that we all enjoy.

We know that the percentage of our population who have diabetes is rising and we know that there are solutions for that, yet here we are today, debating a bill, which is fine, but we are not acting. That is where I have an issue with this situation right now. It is that we need to move forward.

We all have a unified vision that this is a serious issue for all Canadians, and the House and the chamber acknowledge that, but we are still going through a process that is very draconian with regard to getting results for people who are suffering from diabetes. I am really happy to discuss this because it still raises this issue and brings us another step forward, but I hope we can actually go farther than that.

When we look at the issue of diabetes, we see it is one of those things that is affected by the consumer element and the products and foods being pushed onto people. At the same time, we expect people to manage their disease with medication, but some people do not have any choice. Some of us can drive to a grocery store or elsewhere to get food and other supplements that are better choices, rather than having go to stores in their own neighbourhoods, but other people cannot, because they have to take a bus or rely on other people or do not have the support or experience to look at all the ingredients on the labels of the products they need.

The situation is that diabetes is different for those privileged to have an income that allows them to deal with it through a logical plan and provides supports to do those things and make those choices. Then there are other people who have to deal with it but cannot get out of their apartment. They are stuck with limited choices. They do not have the choices that other people have to help themselves. They know that, so they have to do the things necessary just to manage the situation.

I am hoping this motion will propel the government to do something. We can have lots of slogans, different motions, committee studies, all of those different things, but we know diabetes affects people right now, as I am speaking. There are solutions for it, like insulin, which is a pride of our country in terms of its development and use in society, but it is not without cost or effect on populations.

Young people with juvenile diabetes organize and spend their time and their youth fighting for political change by us here, which is a sad thing. How wrong is that? How wrong is it that we are asking young people to spend their time and their youth advocating a public policy we know is true and just? That is what gives me difficulty in this whole situation and what is going on here when we have all of those tools.

We have seen the things that were impossible before COVID-19 and now are possible. We have bailed out banks. A good example is Bell. With $112 million of government assistance, Bell laid off people and made $5 billion in profit, but at the same time we cannot afford strategies for diabetes. Those are good examples of what was impossible before COVID-19 and are possible now.

I am hoping we will see the light with regard to diabetes through the legislation before us, Bill C-237, and other bills that come before the House. I am hoping we will actually start to act. It is important, because none of the debate here really matters, in the sense that it does not affect an individual at the end of the day unless it reaches the goal line. Hopefully, the discussion today will translate to real results.

The Liberal administration had a supermajority in the past Parliament but now has a minority, so we can push things like this forward. I am hoping the government will do that. I do not think we need a five-year study to tell us the effects of diabetes. We do not need more research and development to understand its connection to human bodies and how it affects us as citizens in our communities. We need action.

The discussion here today should be about whether we are going to act or not. That should be the benchmark. The benchmark should be whether we are going to act.

And we should act on this now, not in five years but in five weeks. There should be an initiative to support what needs to be done. The research is there and the population is there, and we can certainly see the inequity in the demographics and research, which shows that people can deal with this issue better if they have money versus not having money, which puts a greater onus on us from the expectations of the population.

It is of even greater importance than ever before for us to act now. Because of COVID-19, we know what we can do to prevent health issues. We can do that with pharmacare, dental care and a series of things, but if we do not act, it does not mean anything. That is the reality. Why do we need another study to understand diabetes? I do not understand that. I will support this bill and the NDP will support it. We will be behind it, pushing really hard for real results, but action is necessary now. It will save us money and give us the opportunity to save lives. I am thankful that this bill has come forward.

[Pam Damoff, Liberal, Parliamentary Secretary to the Minister of Indigenous Services]

Madam Speaker, I would like to begin by acknowledging that I am speaking today on the traditional territory of the Mississaugas of the Credit First Nation. As someone who lives and works on the traditional territories of indigenous peoples, I recognize my responsibility to acknowledge and listen to their perspectives and interests.

I am thankful as well for the opportunity to speak in favour of the member for Brampton South’s private member’s bill to establish a framework for diabetes. I also want to commend her. Since she was elected in 2015, she has been tireless in raising awareness about diabetes and in advocating, as the chair of the diabetes caucus, to ensure the issue receives the attention it deserves. On this International Women's Day, I am so proud to serve in this Parliament with her.

Diabetes is an important public health issue that affects millions of Canadians from coast to coast to coast. Diabetes happens when the body loses its ability to produce or properly use insulin, a hormone that controls blood glucose levels. When diabetes goes undetected or if action is not taken to keep it in check, serious complications can develop, and in some cases, premature death can occur.

As we know, there are three types of diabetes. Type 1 diabetes is an autoimmune disease in which the body is unable to produce enough insulin. It is usually diagnosed in children and young adults and is not preventable. My cousin Adam Fraser and my friend Dave Millar live with type 1 diabetes, and I have seen the challenges they face to manage their disease.

Type 2 diabetes generally develops in adulthood and accounts for 90% of all individuals living with diabetes. It is caused by several factors, including obesity, ethnic background, a family history of type 2 diabetes and other environmental factors.

Gestational diabetes is diabetes that is first diagnosed during pregnancy and usually disappears after delivery.

Many Canadians live with the impacts of this disease. Diabetes or prediabetes affects one in three Canadians. One in two young adults will develop the disease in their remaining lifetime.

Research has shown that some indigenous peoples and Canadians are more susceptible to diabetes than others in the general population. First nations and Métis people, Black Canadians and South Asian Canadians have significantly higher rates of type 2 diabetes than other Canadians. The increased risk for type 2 diabetes in these groups is often a result of inequities in social determinants of health related to income, education and the social and physical environment. These inequities can limit the ability of individuals to access nutritious foods and be physically active, and can increase the risk of obesity, diabetes and other major chronic health conditions.

Higher rates of diabetes among first nations and Métis people reflect the long-standing effects of colonization that disrupted the transmission of culture across generations and resulted in physical changes to the environments of their communities. Among other negative impacts, these factors limit the availability of and access to important sources of nutritious foods as well as the ability to engage in traditional active lifestyles.

The COVID-19 pandemic has exacerbated and unmasked the challenges faced by people living with diabetes. We now know that people living with diabetes are at increased risk of developing severe symptoms and dying from this infectious disease. We also know that people living with diabetes can face significant challenges to participating fully in the economic and social life of Canada. This debilitating disease exacts a significant toll on our nation’s economy and health care system.

I have had the privilege to work with Kimberley Hanson from Diabetes Canada and Mike Swartz from my riding to advance their Diabetes 360 initiative. Both Kim and Mike live with diabetes and have advocated that our government needs to do more. I agree. I sincerely hope our government provides funding to implement Diabetes 360 in our next budget.

A recent study estimated that new cases of diabetes between 2011 and 2021 account for $15.36 billion in health care costs. Beyond the immeasurable human costs of this disease, if prevalence grows by 40% in the next decade, as projected, the health care costs associated with treating people with diabetes in Canada will top $39 billion by 2028.

To reduce the risk of developing type 2 diabetes, the most common and preventable form of the disease, it is important to help Canadians in every way to develop healthier lifestyles. Canadians of all backgrounds and in all regions must have the opportunity to find ways to sit less, move more, eat more healthily and stop smoking.

During the pandemic, at a time when we encourage people to stay home, we can find ways to be active safely, such as going skating, skiing or snowshoeing or bundling up for a hike. Being active and promoting healthier weight are fundamental in helping to prevent type 2 diabetes.

Canada was the first country to develop 24-hour movement guidelines for the early years, children and youth. Through additional guidelines released last year, Canada now has a complete set of recommendations for physical activity, sedentary behaviour and sleep across all age groups.

These guidelines are important in helping Canadians integrate healthy behaviours into their everyday lives, and reduce their risk of major chronic diseases, including type 2 diabetes. Healthy eating is also a key factor in preventing diabetes.

The Government of Canada is taking action to help Canadians eat better and access nutritious foods. Through our healthy eating strategy led by Health Canada, we have strengthened nutrition labelling on food products, eliminated industrially produced trans fats in foods, and are working toward restrictions on the marketing of unhealthy foods to children.

In 2019, we updated and published a new Canada food guide, based on the best evidence available to promote healthy eating. Further, to help Canadians consume less sodium, last fall we released revised sodium targets for processed foods. The Government of Canada is also working with its partners to promote healthy living and prevent chronic diseases, such as diabetes.

Being aware of one’s risk for diabetes is also key to helping people take action to prevent the disease. The Public Health Agency of Canada, in collaboration with its partners, developed and promotes a diabetes risk questionnaire called CANRISK to help Canadians understand their level of risk for developing pre-diabetes and type 2 diabetes.

The Government of Canada is also investing in innovative community-based programming and public education to test and scale up projects that help to prevent chronic diseases, such as diabetes, and encourage healthy living choices. The government is providing extensive support for diabetes research. From 2014 to 2019, the Government of Canada, through the Canadian Institutes of Health Research, invested approximately $229 million in diabetes research.

This year marks the 100th anniversary of the discovery of insulin. I grew up in London Ontario, the home of Sir Frederick Banting. One of my high school’s rivals was Sir Frederick Banting Secondary School. Canadians should indeed be proud of the work that Banting and Best did with their discovery of insulin.

The Government of Canada is working with partners to commemorate this monumental Canadian innovation that has saved millions of lives world-wide. However, while this milestone is indeed worthy of celebration and a source of pride, we have more to do. Diabetes Canada has stated:

When the world looks to Canada in 2021 to see how we are faring at treating diabetes 100 years later, Canadians will have less to feel proud of. Double the number of Canadians lives with diabetes than did 15 years ago, and Canada is in the worst third of developed countries for both prevalence and costs of treating the disease. The problem of diabetes is very bad, and rapidly getting worse. We need to do something bold to address this problem and mark this important anniversary in 2021.

Eleven million Canadians are living with diabetes or prediabetes. Chances are, the disease affects someone or someone they know.

I am pleased to support Bill C-237 as the government continues to undertake meaningful efforts toward preventing and reducing the impact of diabetes and other chronic diseases on Canadians. This bill reminds us that we need to increase our efforts and work together, alongside individuals living with diabetes, to reduce the burden of this devastating disease and improve health outcomes for Canadians and indigenous peoples.

Finally, I would like to again thank the member for Brampton South for bringing this bill before the House of Commons and for her tireless advocacy.

[Ted Falk, Conservative, Provencher, MB]

Madam Speaker, Mitch Beauchemin was a lifelong resident of Ile des Chênes, Manitoba, in my my riding of Provencher. His family and friends described him as a quiet, gentle and generous individual, always ready to lend a helping hand, yet never needing recognition.

I am going to give him a little recognition this morning. Mitch was a member of the Ile des Chênes Knights of Columbus Council and an advocate for Diabetes Manitoba. He was passionate about supporting those living with diabetes, and he actively lobbied the government on behalf of those with the disease.

Mitch was not just an advocate; he lived with type 1 diabetes for 40 years. Then, early last year, Mitch was able to receive a kidney and pancreas transplant, effectively closing the chapter on decades of managing his diabetes.

Sadly, he passed away this past September, but not without leaving his mark. In 2016, I was invited to be one of several guest speakers at a fundraiser Mitch organized called “Let's Get Pumped”, with proceeds going to the Canadian Diabetes Association. It had all the trappings: a luncheon, live music, speakers and a silent auction, and a 50/50 draw. He was quoted in the Niverville Citizen at the time saying that he wanted to do this event, not only because of his own experience but also for all diabetics in the province.

Beyond this event, my office heard from Mitch from time to time, always making sure that diabetes was top of mind for decision-makers. Though I know many, including his wife, Cathy are missing him dearly, his memory lives on.

It is a pleasure to have this opportunity to speak to Bill C-237, the national framework for diabetes bill. I would like to think that Mitch would be pleased to see this conversation taking place today in this house in Parliament. I want to thank my colleague, the member for Brampton South, for bringing forward this legislation. Her advocacy has been generating general awareness about diabetes for several years now.

As Diabetes Canada so succinctly puts it, “Diabetes is a disease in which your body either can't produce insulin or can't properly use the insulin it produces.”

Some 11 million Canadians are living with diabetes or pre-diabetes. If we consider an average 24-hour period, about 20 Canadians will die as a result of diabetes complications; 620 will receive a diabetes diagnosis, and 14 of them will have their lower limbs amputated. These numbers represent real people, family members, friends and neighbours, whose lives have been lost or dramatically changed as a result of this disease.

The national framework for diabetes bill seeks to develop a national framework designed to support improved access to diabetes prevention and treatment to ensure better health.

It looks to include measures to explain what diabetes and prediabetes are, identify the training and education needs of health care professionals related to the prevention and treatment of diabetes, and promote research and improve data collection.

Bill C-237 would also require the Minister of Health to hold at least one conference with relevant stakeholders to develop this framework, and within one year from when this act comes into force, the minister would have to report to the House on this framework. This is an important accountability mechanism that would ensure that the minister would do the work necessary to build this framework, although we must also be wary that there is no guarantee that the minister would meaningfully address issues that diabetics face here in Canada.

Canadians should have stable and reasonable access to the health care and the treatments they need. By working with stakeholders like Diabetes Canada we can take concrete steps forward to develop a plan for the prevention and management of diabetes in Canada through a national strategy.

When the health committee studied this subject in 2019, it made important recommendations that bear mentioning. The first one was that the Government of Canada, in partnership with provinces and territories, and in collaboration with stakeholders, such as Diabetes Canada, plan and implement an approach to the prevention and management of diabetes in Canada through a national diabetes strategy.

Second, as part of a national diabetes strategy, the Government of Canada, in partnership with the provinces and territories, and in collaboration with stakeholders, such as Diabetes Canada, should explore options for establishing a national diabetes registry for people living with both type 1 and type 2 diabetes; explore options to reduce diabetes-related stigma; and, finally, explore options to improve public health awareness and education on diabetes, particularly through community programming, including public awareness of the relationship between nutrition and diabetes.

The bill serves to answer the call of these 2019 recommendations, but it is worth noting that programming already exists to address common risk factors of diabetes within the integrated strategy on healthy living and chronic disease. In going forward with the bill, there must be clarity about how the national strategy would tie in with existing programming.

A number of previous governments have taken important steps forward on diabetes as well. In 1999, the federal government created the Canadian diabetes strategy to further the prevention, early detection and self-management of diabetes and its complications, and national surveillance. It committed $115 million over five years for that strategy. In 2005, the Canadian diabetes strategy became part of the integral strategy on healthy living and chronic disease. Funding for the Canadian diabetes strategy was renewed in 2005 and $18 million a year was introduced for the Public Health Agency of Canada's diabetes programming. Funding for diabetes research is also disbursed through the Canadian Institutes of Health Research. In 2010-11, under the previous Conservative government, the Canadian Institutes of Health Research funded approximately $44 million in diabetes research.

As I reviewed this history, I was struck by the gap between the previous Conservative government's funding and where we find ourselves today. When the health committee's recommendations that I highlighted earlier were laid out, the committee had a Liberal majority, which was supported by Conservative members of the health committee, and it was understood that the government needed to act. Unfortunately, we have not seen much action by the current Liberal government in recent years. As a government, it could have introduced a government bill, but no such bill was introduced—not when the Liberals had a majority and not now in the current Parliament. Had they chosen to introduce a government bill, Parliament could already have had work under way to develop this framework. Bill C-237 is important, but Canadians with diabetes also know that it is late.

It is also troubling that the Liberal government's most memorable connection to diabetes is when it oversaw a Canada Revenue Agency crackdown on access to the disability tax credit, which is a non-refundable tax credit that helps persons with diabetes reduce the amount of income tax they might have to pay. In 2017, the CRA began restricting access to this disability tax credit, which affected hundreds of Canadians living with diabetes and other rare diseases. This happened because officials changed the interpretation of the rules around life-sustaining therapy and associated requirements for those diseases. Our Conservative opposition sounded the alarm and stood with organizations demanding that Canadians continue to receive the benefits they ought to have access to. Given this history, I think there would be value in including an amendment to ensure that the Canada Revenue Agency is administering the disability tax credit fairly and that the disability tax credit is designed to help as many persons with diabetes as possible. This is something that the committee can look at when the bill is referred to it. I think we can all see how this would give greater certainty to those folks who rely on the disability tax credit.

It is my duty as an opposition member to constructively critique the proposal. I have highlighted where I think it could be better, but I do not want to dwell on that. I appreciate that the member for Brampton South is stepping up in the absence of action from her government. She is using the opportunity that she has been afforded through the private members' bill lottery to move the dial forward on this issue, and I commend her for that. At a time when so much attention has been dedicated to COVID-19, it can be easy to forget that the daily challenges faced by individuals with diabetes have continued without their receiving much media attention and without widely publicized diagnosis.

The final word is this: There is merit to committed and coordinated federal leadership to tackle diabetes in Canada. We have an opportunity to move the ball forward and a strategy that could help support those living with diabetes and help prevent millions of potential cases. As I said before, we are talking about real people, and this could better the lives of millions today and in the future. I encourage all members to move the bill forward to committee so that we can take a long overdue step.

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I would like to thank all the members who spoke to this bill: the members for South Okanagan—West Kootenay, Winnipeg North, Calgary Shepard, Abitibi—Témiscamingue, Windsor West, Oakville North—Burlington and Provencher, and the members who spoke during the first hour of debate. The member for West Nova, whom I serve with on the health committee, spoke about his son's diagnosis. The member for Shefford told us about her relative's diagnosis. My friend from Brampton North told us about her grandmother and her childhood friend who would later pass from complications related to diabetes. There are too many heartbreaking stories like these.

Almost 11 million Canadians live with diabetes or prediabetes. The number of diagnoses has doubled in the past 20 years, and every three minutes another Canadian is added to the list. In my city of Brampton, every sixth Bramptonian lives with this disease.

For 18 years, working in health care, I saw how diabetes impacts Canadians. Often I would see patients with cardiovascular disease, kidney disease, amputation or high blood pressure, and diabetes was often an underlying and complicating condition. Diabetes also disproportionately impacts Canada's indigenous and racialized communities because of socio-economic factors.

In the last term, I met with Canadians through my cross-country consultation and with world-leading experts through international conferences. If we rededicate our efforts in reducing the number of cases and improving treatment and care for those living with this disease, we make progress in the battle against diabetes.

I would like to take a moment to thank the individuals who have supported this bill and helped it come together. I want to thank the mayor of the city of Brampton, Mayor Brown; city council members, including Councillor Medeiros; the Peel medical officer of health, Dr. Lawrence Loh; great advocates like Laura Syron, Russell Williams and Kim Hanson at Diabetes Canada; organizations like JDRF, CNIB and the Canadian Nurses Association; and of course my colleagues in the all-party diabetes caucus and the JDRF caucus, as well as many others.

As someone who has served on the Standing Committee on Health since 2016, I was proud when we brought forward a report calling for a strategy, such as Diabetes 360°, to fight diabetes. It was concluded that diabetes would cost Canadians almost $40 billion a year by 2028. We need to work with the provinces and territories, indigenous groups, medical professionals and community organizations so that we can best serve patients living with diabetes and advance the research that will end it.

Bill C-237 calls on the government to do that and create a national framework for diabetes. As parliamentarians, let us recommit to helping everyone battling this chronic disease, whether they are patients, doctors, researchers or loved ones, and continue fighting it so that more Canadians can lead a healthy life.

This year we commemorate the 100th anniversary of the discovery of insulin by Frederick Banting, which is recognized as one of the most important medical discoveries of the 20th century. Since then, we have continued to lead the way with stem cell research, which could one day lead to a cure.

Canada gave insulin to the world. Why can we not lead the way in defeating diabetes? I hope all members will join me in supporting my bill, Bill C-237.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

I want to remind members, if they know they are coming up to speak, to make sure their mikes are selected correctly before they start to ensure that the interpreters are able to interpret what they are saying in both official languages. We do appreciate the fact that documentation is being provided ahead of time, which means if there is an issue, the interpreters are still able to continue to interpret.

The question is on the motion.

If a member of a recognized party present in the House wishes to request a recorded division or that the motion be adopted on division, I would invite them to rise and indicate it to the Chair.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I request a recorded division.

[The Assistant Deputy Speaker, NDP, Carol Hughes]

Pursuant to order made Monday, January 25, the recorded division stands deferred until Wednesday, March 10, at the expiry of the time provided for Oral Questions.