National Framework for Diabetes Act

An Act to establish a national framework for diabetes

This bill was last introduced in the 43rd Parliament, 2nd Session, which ended in August 2021.

This bill was previously introduced in the 43rd Parliament, 1st Session.

Sponsor

Sonia Sidhu  Liberal

Introduced as a private member’s bill.

Status

This bill has received Royal Assent and is now law.

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

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

Elsewhere

All sorts of information on this bill is available at LEGISinfo, provided by the Library of Parliament. You can also read the full text of the bill.

Votes

June 2, 2021 Passed 3rd reading and adoption of Bill C-237, An Act to establish a national framework for diabetes
March 10, 2021 Passed 2nd reading of Bill C-237, An Act to establish a national framework for diabetes

National Framework for Diabetes ActPrivate Members' Business

May 26th, 2021 / 6:10 p.m.
See context

Bloc

Luc Desilets Bloc Rivière-des-Mille-Îles, QC

Mr. Speaker, we are here this evening to discuss Bill C-237, otherwise known as an act to establish a national framework for diabetes.

The purpose of this legislation is to promote and improve access to diabetes prevention and treatment. It is sponsored by my colleague from Brampton South and is going into the third stage, in other words, third reading.

To summarize Bill C-237, it seeks to explain what diabetes and prediabetes are; identify the training, education and guidance needs of health care and other professionals related to the prevention and treatment of diabetes; promote research and improve data collection in order to enhance the knowledge and information sharing required to conduct research; and ensure that the Canada Revenue Agency is administering the disability tax credit fairly so that it can help as many persons with diabetes as possible.

The legislation gives the government one year to develop the policy framework, and within five years the government must evaluate its effectiveness and revise it, of course, if necessary.

It should be noted that since 2016 Health Canada's Centre for Chronic Disease Prevention and Control has been managing the diabetes strategy. This plan is very general and contains more policy statements than meaningful measures.

Key aspects are essentially the same as the previous plan. That is why countless organizations are calling for a national plan or framework.

The Bloc Québécois is in favour of developing a national framework for diabetes. To oppose it in light of the medical catastrophe that this chronic disease represents would be just wrong.

However, it is imperative that this framework be developed with the demands of Quebec and the provinces in mind and, again, that the division of powers be respected.

In a way, health is a competitive jurisdiction since it involves some overlap between the provincial and federal governments. In the area of health, Quebec must have maximum authority and control. That is what we want and that is what we will have.

The federal government does have a role to play in prevention, and that includes working to stop the rampant obesity rates in this country. Obesity significantly increases a person's chance of becoming diabetic. Although Quebec is doing well compared to the other Canadian provinces and many major countries in the world, one in four Quebeckers is obese and will be obese in the coming years.

Diabetes Canada, the most influential diabetes organization in Canada, does not operate in Quebec. Instead, Quebec is fortunate to have Diabetes Québec, which provides information and support to its members and contributes to research. In 1994, the organization even founded Entraide diabétique du Québec, a separate organization that collects donations to help people with diabetes.

There are three main types of diabetes: type 1 diabetes, type 2 diabetes and gestational diabetes. In all three types, the disease is characterized by chronic hyperglycemia, or high blood sugar, which means that the person's glucose levels are too high.

Insulin abnormalities mean that sugar does not enter the body's cells to provide energy, but remains in the bloodstream anyway. This condition, which is lethal if left untreated, has a strong impact on susceptibility to cardiovascular disease, blindness and kidney failure, among others. Obviously, this type of disease can lead to limb amputations due to the factors listed previously.

With 442 million adults affected worldwide, diabetes truly is a global scourge, and Quebec is not spared. According to the Public Health Agency of Canada, one in 10 Quebeckers has diabetes or pre-diabetes. The financial burden of diabetes is naturally staggering. According to Quebec's public health department, we are talking about $3 billion a year.

The good news is that almost 90% of type 2 diabetes cases can be prevented or even cured by adopting healthy lifestyle habits. This is why it is imperative to take preventive action by educating people about healthy lifestyle habits, including good nutrition and exercise.

However, we would be deluding ourselves if we thought that the ball is entirely in our court. The sugar lobbies are obviously working hard to slow down, dilute or nip in the bud any form of legislation that might seek to reduce refined sugars.

Legislating for a tax on products containing refined sugar, honest labelling or a restriction on the advertising of these products would prove to be a difficult but necessary task.

Conversely, we must also point out that the diabetes epidemic is a boon for pharmaceutical companies. In 2016, global profits from sales of insulin reached almost $50 billion. It is extremely difficult to conduct an effective prevention campaign when going up against powerful pharmaceutical companies, which boast that they can help people with diabetes live a normal life, even though that may be stretching the truth.

While waiting to win this battle, it is vital that we continue and even redouble our efforts to provide adequate services. Medical research is making great strides, but it is not enough. We also know which communities are the most vulnerable to diabetes. In Quebec and Canada, it is first nations. The rate of diabetes in these communities is five times greater than that in Quebec and Canada.

To address this problem, Health Canada has invested approximately $50 million per year since 1989, mainly through the aboriginal diabetes initiative. Organizations are tasked with working with indigenous peoples to reduce health inequalities. At this time, much more still has to be done, and the federal government will have to invest far more than $50 million a year to reverse the current trend. That, however, is a debate for another day.

It was exactly 100 years ago in Ontario, in the magnificent country of Canada, that insulin was discovered by a team of medical researchers. For their work, Frederick Banting and John Macleod were awarded the Nobel Prize in Medicine two years later, in 1923.

As a pioneer in diabetes research and its treatment, Canada must have a clear and ambitious national framework. Nevertheless, the Bloc Québécois's support is contingent on the federal government respecting input from the provinces and Quebec and on the division of powers, which is what the Bloc Québécois wants. We will vote in favour of the bill as is because it does meet all the necessary criteria so far. Bill C-237 does not promise to eradicate the scourge of diabetes within the next few years, but it is a very acceptable solution even so.

Before I wrap up, I want to highlight the work of an organization in my riding, the Association du diabète Laval, Laurentides, which has been working tirelessly since 1984 to educate people about diabetes and share knowledge through presentations and workshops.

I would like to take this opportunity to thank hospitals and clinics in my riding and the rest of Quebec for the work they do every day to fight diabetes.

I applaud the medical professionals responsible for diagnosing and supporting patients with diabetes and improving their quality of life.

Lastly, I want to thank the researchers—

National Framework for Diabetes ActPrivate Members' Business

May 26th, 2021 / 6:20 p.m.
See context

NDP

Lindsay Mathyssen NDP London—Fanshawe, ON

Mr. Speaker, I appreciate the opportunity to rise to speak to this bill to establish a national framework for diabetes.

Currently, more than six million Canadians are living with diabetes and the health and financial costs associated with it. Today, many Canadians living with diabetes are unable to afford the medications, devices and supplies they need. We also know there are even larger costs related to non-adherence that can lead to avoidable complications and sometimes even worse.

This is especially true for too many families that I represent in London—Fanshawe. I have heard from folks who struggle with being able to put food on the table and to keep up with the rising costs of housing and with the large and rising costs of medication. They are often faced with an impossible choice.

One person I spoke to talked about paying their bills every month, and called it creative financing: the bills they skip this month they pay the next month; what medications can they choose to stretch or which prescriptions must they leave unfilled. Sadly, these choices can lead to poor health outcomes and hardship. They also have to live with the choices that federal and provincial governments make that too often overlook them and cause them a lifetime of greater suffering.

I cannot imagine a family in Canada that has not been impacted by diabetes. Mine certainly has. My grandfather lived with diabetes, but he was fortunate to have a unionized job. He was a steelworker and his union ensured that he had benefits and drug coverage. However, for far too many Canadians, a well-paying job with benefits is not a reality.

We have also seen throughout the COVID-19 pandemic how the massive downturn in the economy has come with the shutdown of workplaces, and this can lead to many people losing those benefits and often at a time when they need them the most.

The New Democrats believe the federal government must support the development and implementation of a new national diabetes strategy based on the Diabetes 360º framework that was developed in 2018 by Diabetes Canada and dozens of other stakeholder groups. The government should also facilitate the creation of type 1 diabetes and indigenous-specific strategic approaches, the latter to be led and owned by indigenous communities.

The Government of Canada must support indigenous-led programs. Indigenous communities are asking for services and research, the prioritization of food sovereignty, access to culturally appropriate care and treatment options, traditional healers and medicines. They are also asking for any assistance to raise awareness about gestational diabetes and the increase in diabetes among young indigenous women.

In addition, the New Democrats believe that there is an urgent need for a universal public pharmacare plan that would ensure all Canadians living with diabetes would 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. There have been incredible technological advancements that help people living with diabetes monitor their insulin levels through apps on their cellphones, but these are expensive and out of reach for too many Canadians.

Canada has no formal national strategy to address diabetes, one of the most significant health care crises of our time according to Diabetes Canada. Although the World Health Organization recommends every country have a national diabetes strategy, Canada's previous strategy fizzled away in 2013, followed by a scathing report on its underperformance by the auditor general.

Depending on where people live in Canada, what other private insurance they have and what their treatment protocol is for their diabetes, it can cost a patient out of pocket up to $15,000 a year to live with diabetes, and that is unacceptable. However, other provincial governments are providing leadership on this front.

For example, the current B.C. NDP government expanded its pharmacare coverage for diabetics aged 25 and older to use insulin pumps instead of relying on daily injections to stabilize their condition. Under the former Nova Scotia NDP government, the province extended coverage for the cost of insulin pumps and supplies for eligible youth aged to 18, and supplies for people 19 to 25 with type 1 diabetes who used an insulin pump. Under the former NDP government in Manitoba, the province brought in a program to cover the cost of pumps for youth. These were all positive steps made by current and former NDP governments across Canada.

I wish I could say that we are seeing similar positive steps in my home province of Ontario. Earlier this month, the Ontario Conservative government voted down NDP MPP Taras Natyshak's Bill 272 that called on the government to add continuous glucose monitoring and flash monitoring devices to Ontario's assistive devices program for Ontarians diagnosed with type 1 diabetes. This bill would have made life easier and more affordable, removing financial barriers to technology that would make it easier to manage diabetes and would remove the need for the frequent finger pricks. It is said that the provincial Conservative government could not have seen the merits in passing it.

There is an estimated one in three Ontarians living with diabetes or pre-diabetes, approximately 4.3 million people. People in Ontario and across Canada need to see a government that will support them and, of course, the principles outlined in the Canada Health Act, which are clear about universal health coverage. It is clear that we need a national framework to bring expanded coverage for Canadians, no matter the government, no matter the province and no matter the postal code.

Any national framework needs to be backed up with a national universal pharmacare plan. A recent report from the Canadian Federation of Nurses Unions found that 57% of Canadians with diabetes reported failing to adhere to their prescribed therapies due to affordability issues related to medications, devices and supplies.

The Liberals say the right things when it comes to pharmacare, but when it comes time to act, they put the profits of big pharmaceutical and insurance companies ahead of what Canadian families need. The Liberals have been promising pharmacare for 23 years, but Canadians are still facing sky-high prescription costs that make it hard to make ends meet. Right now, millions of families cannot afford to take the medications they need because they have no drug coverage. The number of uninsured people forced to skip their medications is growing, and with the COVID-19 pandemic, most people work on contract or are self-employed or have jobs that do not come with health benefits or have no job at all. As well, too many seniors are putting their health at risk because they do not have that drug coverage and they cannot afford to pay out of pocket for their medications.

Bulk buying of pharmaceuticals undercuts inflated prescription costs set by private companies and would let us lower costs dramatically by negotiating prices as an entire country. We could save $4.2 billion and use that money to give better health coverage to all Canadians. A national framework for diabetes combined with a national universal pharmacare plan would have a direct impact on families across Canada and families in my riding of London—Fanshawe.

The lack of dedicated support or action to tackle the diabetes epidemic means that every 24 hours more than 20 Canadians die of diabetes-related complications, 14 have a lower limb amputated, 480 more are diagnosed with the disease, and the health care system spends $75 million treating patients with the disease. It does not have to be this way, but we need a government that has the political will and courage to get it done.

It would be a missed opportunity on the eve of the 100th anniversary of the discovery of insulin in Canada if we fail to ensure that every Canadian living with diabetes can afford access to insulin. Of course, as a proud Londoner, it would be a failed opportunity if I did not mention this anniversary as well. In 1921, Dr. Frederick Banting, Charles Best, James Collip and their supervisor, John Macleod discovered insulin. This discovery revolutionized the treatment of diabetes worldwide and remains among the most celebrated medical discoveries in Canadian history.

Yet today, many Canadians living with type 1 or type 2 diabetes are unable to afford the medications, devices and supplies they need. I cannot imagine this is the outcome that Banting, Best and Collip wanted or imagined when they were awarded the American patents for insulin, which they sold to the University of Toronto for $1 each.

Located in London, Ontario is the house of Sir Frederick Banting.

Under the stewardship of Diabetes Canada, Banting House National Historic Site of Canada creates public awareness and understanding of the national historic significance of Sir Frederick Banting and preserves the commemorative integrity of Banting House, the birthplace of insulin, for the benefit of the people of Canada.

Many Canadians still fight for the dream that we do not profit off each other's illness, that we grow as people and as a society, that we take care of each other. It can be disheartening to see a government continue to be heavily lobbied by large pharmaceutical companies and, even more so, that it seems to listen. That is why New Democrats support the creation of a national framework for diabetes, and we will not stop fighting for a national universal pharmacare plan.

Tommy Douglas, the father of medicare, did not intend to limit it to hospitals and doctors alone. The coverage of drugs and other services, like dental care, ear and eye care, and long-term care, was to follow. That is why I will conclude my speech tonight with a quote from Tommy Douglas: “Courage, my friends; 'tis not too late to build a better world.”

National Framework for Diabetes ActPrivate Members' Business

May 26th, 2021 / 6:30 p.m.
See context

Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Mr. Speaker, it is an honour to rise today to speak to this private member's bill, which has been brought forward by the member for Brampton South. I want to congratulate her on taking her private member's opportunity to bring forward a bill or motion and put it to such a meaningful and important cause.

I used to sit very close to the member for Brampton South in the House, and I know her passion for health care and making sure that the most vulnerable in our communities, especially as related to health, are taken care of. In the last session of Parliament, on a number of occasions while sitting next to each other, she talked to me about the need for something to be done nationally on diabetes. In this Parliament's lottery, she was very lucky to have her spot near the top of the list and had an opportunity to do something. To see this bill brought forward by the member for Brampton South is truly rewarding, because I now that she is doing something that she is extremely passionate about. Indeed, she has been a leader in bringing members from different parties in this House together to talk about diabetes and the strategy that the federal government should take.

When we talk about a disease that affects over three million Canadians, I must admit that I was kind of surprised to learn that we did not already have a strategy of some form in place as it relates to making sure that we have a coordinated effort across the country in fighting diabetes. As indicated by a number of people in this House in the previous hour of debate on this bill, it is something that affects so many Canadians and their quality of life.

In many instances, diabetes is a preventable disease. Of the roughly 200,000 Canadians newly diagnosed with diabetes, approximately 90% is the preventable type 2. When we think of the growth in the aging Canadian population, the number of Canadians expected to live with diabetes obviously grows as well. Putting in measures to make sure that we have a national strategy as it relates to educating health care professionals on how to prevent and treat diabetes is critical, probably more important than at any time previously in fighting this particular disease, with the exception, of course, as mentioned by the previous speaker from the NDP, of the invention of insulin.

I am so glad to see so much support throughout the House from various parties, and it appears as if the bill might pass unanimously. It is telling of how this Parliament can come together and work together here in this place, but also show the desire to work with our counterparts at the provincial, territorial and municipal levels to make sure that all Canadians throughout Canada can have a meaningful framework in place so they are taken care of in the event they get diabetes and, in fact, to help prevent that from being the case.

It is very rewarding and I am very proud to be part of a government that has brought forward many initiatives on health care throughout the various budgets that have been presented since 2015. I would note that, in budget 2021, there is $25 million over a five-year period, starting in 2021, specifically for Health Canada for additional investments in research on diabetes, specifically juvenile diabetes, surveillance and prevention, and to work towards developing a national framework on diabetes.

This private member's bill dovetails nicely with what this government is already in the course of doing in terms of making sure that we continue to advance the research, prevention and education around diabetes. Indeed, Bill C-237 will be developed in consultation with provinces and territories, indigenous groups and other stakeholders to help support improved access to prevention and treatment and better health outcomes for all Canadians.

One of the various elements that have been brought forward is the $25 million over five years, which I mentioned, but in budget 2021 there is also a proposal for $10 million over five years for the Public Health Agency of Canada for a new diabetes challenge prize. Specifically, this initiative would help surface novel approaches to diabetes prevention and promote the development and testing of new interventions to reduce the risks associated with type 2 diabetes.

As has been illustrated by both the government approach and members of this House, including the member who brought forward this bill and members from other parties who have been speaking in favour of it, this is something this Parliament really does see as an opportunity to seize on this issue and to advance the objectives of Parliament and those health objectives for the benefit of all Canadians. I am very proud to be supporting this. Knowing we can have such a great impact on the lives of so many Canadians is something deeply meaningful to all members of this House.

I will conclude with where I started, which is that I am very encouraged to see this member use her opportunity through this private member's bill to bring forward something that will have a meaningful, large impact on a number of Canadians throughout this country. Indeed, if the national strategy is developed in the right way and brought forward in a way that really helps prevent people from getting diabetes, the value of her impact will be immeasurable, because down the road many people may end up not getting type 2 diabetes in particular because of the prevention measures that would be put in place here.

This member knows a lot about this topic. As I indicated before, she was very passionate about it and spoke very passionately about it. I know that before coming into Parliament she was in the health profession specifically. I always like to see examples of people who come to this House with previous knowledge outside of government and its workings, people who have a specific passion, perhaps from a former profession, and bring it here and apply it to policy. What could be more rewarding than working in a profession and then bringing it to the seat of democracy for our nation and putting that knowledge into actual, practical use and turning it into legislation, as it appears this member will be doing through this bill, given the fact that all parties have indicated they are going to be supporting it?

I will not use up any more time, but I am very much looking forward to adopting this and having a vote on it at the end of this hour of debate, and moving on with this strategy so we can see the national framework be developed for all Canadians.

National Framework for Diabetes ActPrivate Members' Business

May 26th, 2021 / 6:40 p.m.
See context

Conservative

Karen Vecchio Conservative Elgin—Middlesex—London, ON

Mr. Speaker, I would like to thank all of the speakers tonight because I think they have brought so much warmth to this discussion. The fact is that diabetes, as all speakers have said, is something that is preventable in 90% of cases. I think this is a great time to all join together and talk about this.

I am so glad it is you in the chair, Mr. Speaker, because I can share with you the types of phrases that are used in my house, or my mom and dad's house, every day. Any time I walk into my parents' house I hear, “Karen, your father's sugar is high. Ask your dad how many cookies he ate today. Your father's sugar was at 15 and he is miserable." This is all I hear: “Your father's sugar is high” and “Karen, are you watching your sugar?” These are my parents. They love me.

I am from a family where many of my elderly relatives have been challenged with diabetes. That is why I am so happy to speak on this bill today, Bill C-237, a national framework for diabetes act, which is focused on prevention and treatment. According to Diabetes Canada, there are 11 million Canadians living with diabetes or prediabetes. These are really important things, so we have to understand the three different types of diabetes there are and what we can do as well.

I am going to start off with the least simple one, which is type 1 diabetes, and then I will talk about what many of us have discussed, which is type 2 diabetes.

Type 1 is an autoimmune condition where the immune system mistakenly attacks and destroys the beta cells in the pancreas that produce insulin. The damage is permanent. If we look at who is going to have these issues, we recognize that type 1 diabetes mostly impacts people before the age of 35, though it can develop later on in life as well.

It is one of those things that people are born with, or there is something determining that they will end up with type 1 diabetes, whether genetics or whatever it may be. There is no solution to what is causing these issues. These are things I think many families are very concerned with because having a child who has diabetes is life altering. This is something I look at as a mom.

The research being done through our juvenile diabetes associations and all of those groups is really important because of the impact type 1 diabetes has, especially on our youth. I am sure everybody in this House has probably seen a young person on a field playing soccer, baseball, or whatever it may be, with a pump on their side.

The first time I saw that was probably about 15 years ago. A young girl came to my house to visit with the kids and she had her own insulin pump. It is incredible to think of this very active child and of her parents knowing she is on the soccer field and there is a chance of her passing out or having issues at any time. This national strategy is important because it would help all families.

We understand this form of diabetes is an autoimmune disease where the body is not able to create insulin, so we have to ensure we have the technology and the advancements to make sure that person has a whole life. I am talking about these young children. Earlier in my career, I had some people come in from the Juvenile Diabetes Research Foundation, the JDRF.

It was great when they came in because they were talking about some of these little pieces they were wearing on their hips that showed how many carbohydrates they had in their diet, what proteins and all of these things. Having a framework and funding is so important because this is a disease we can do more about.

Type 2 diabetes is something that we talk about most often, and 90% of diabetes cases are type 2. This has more to do with insulin resistance, where the insulin hormone is not used efficiently. That takes me back to first year university biology, when we talked about the impacts on the kidneys if the pancreas is not working, which can have a very negative effect on a person's life.

We will talk more about that because I think, when talking about type 2 diabetes, we can really pinpoint what we can do. There truly is a path to limit and reduce the number of people who are living with diabetes. There is prevention, and that is why I think this is a really important strategy as well.

Gestational diabetes is an issue that pregnant women have when insulin-blocking hormones occur, and we see many women going through their last weeks of pregnancy with diabetes. In many cases, it goes away quickly and they will be fine, but there are some cases we have to be concerned with.

Diabetes, as I indicated, has been an important part of my life. I think of my family members who have lived with it. I remember back in the mid-1970s when my grandmother came to live with us because she had to have her leg amputated due to diabetes. Of the common issues there are with diabetes, amputation seems to be very common, especially when we are talking about 45 years ago. It is incredible to see how things have changed in the last 45 years. We are not seeing as many amputations. We are seeing that proper care and maintenance that needs to be done.

With someone who has type 2 diabetes, we have to be worried about heart and stroke issues, nerve damage, and the eyes and retinopathy. There are many factors that we use to control and manage these things. That is why I think that with type 2 diabetes, we really need to look at a national strategy.

This plan would be very useful in seeing how can we have a national strategy that really takes some of the best practices from our provinces and territories. We can work together, ensure that the research is being done and see how we can assist by funding. We can assist the provinces and territories in recognizing that we are a partner here. We are not the main game holder, but we can enhance people's lives.

In some of the key factors of managing and controlling, we need to look at nutrition and fitness, including meal planning, healthy eating, exercise and activity, and weight management. To drill down into this more specifically, I pulled out a report from 2012 done by the Government of Ontario focusing on some of the key recommendations. Many of the diabetes factors and many of the things we can move forward on are truly common sense things.

For instance, we can reduce obesity. We know that being overweight is a key factor to diabetes. What can we do? How can we ensure that somebody is going to increasing their physical fitness and activity? We know that with insulin, when someone is exercising, it is more controlled. Over those two or three hours of exercising, one's glucose tolerance actually starts to change with those activities. People should be aware of this.

We know that overall the physical exercise someone does will give them better health, including for their heart. We need to make sure that we are maintaining healthy weights. That is something I will be very honest about. I am not sure what I would be at a healthy weight. We know that, especially women. We can look at stress as another factor that can lead to this. Right now people are sitting at home due to stress, due to COVID and doing different routines.

We know a lot of people have packed on what some people call the “COVID 15”, or the “frosh 15”, if one went to university back in the nineties. A lot of people have gained a lot of extra weight. What are some things that we can do to ensure people are going to be healthy again? We know that maintaining a healthy meal plan and making sure we are eating proper foods are other ways of doing so, by having a healthy diet. Another thing is not to smoke. We know that with diabetes, smoking is something that can cause great complications.

I heard my colleague from the Bloc indicate this also, and I am very proud, being from Elgin—Middlesex—London, that we have a statue honouring Sir Frederick Banting who, in 1923, along with John James Rickard Macleod, was awarded the Nobel Prize in Medicine. They codiscovered insulin. This is the type of great work that we need to do. This was over a century ago. This is what we need to do. This is what makes our country better.

I really like the direction we are going in. I recognize that members from the government have talked about all the funding they have given and what they are doing for this. I just hope they stay on target, stay focused and get it done right. We know a lot of times that sometimes we may put money into it, but we are not sure if it is being spent properly. Are we focusing on what the provinces and territories need? How can we do that? I hope we do get it right.

To the member who put this forward, I do have great respect for her. I know she was one of the persons putting a motion forward so that we studied this in HESA. It is really important that we are doing that as well. I hope that we get this right.

This is something that we can do together. This is something that we should be proud of, if we come up with a strategy that works. I wish everyone the best on this going forward to make sure it gets to committee and we can look at it as thoroughly as possible.

National Framework for Diabetes ActPrivate Members' Business

May 26th, 2021 / 6:50 p.m.
See context

Bloc

Christine Normandin Bloc Saint-Jean, QC

Mr. Speaker, I, too, am pleased to speak to Bill C-237 on a national framework for diabetes, which was introduced by the member for Brampton South.

I think it is worth pointing out that we are talking about a bill and not a national strategy, even though we have had a lot of discussions about this in the past. The advantage of a bill is that the legal framework makes it possible to ensure better enforcement and better follow-up.

The bill states that the government has one year to establish the strategic framework and that it must assess the effectiveness of this national strategy five years after the report is tabled. That means that the bill already sets out a schedule and includes it in a legal framework, which is a positive step forward.

I am saying that because I am referring to the work that the Standing Committee on Health did after second reading and because my colleague from Montcalm asked the sponsor of Bill C-237, the member for Brampton South, some questions about the difference between what is happening now with the legal framework and the discussions that took place in the past with regard to national strategies. There have been discussions since 2005, and there have been debates about Diabetes 360° since 2018, so we wanted to know why we now need a legislative framework for all of this.

We were told that having a legislative framework is ultimately a good thing. It ensures that these intentions are not just wishful thinking and that there is follow-through.

Ms. Hanson of Diabetes Canada was asked about Diabetes 360°, the strategy that was recommended three times in a row and is also included in budget 2021. She was asked if the government had backed the strategy with funding. She answered that it had not yet done so.

After conducting a study on a national strategy, the Standing Committee on Health issued its recommendations. We tried to determine if these recommendations had been implemented by the government. It was not clear.

Thanks to the work of members, we now have a legislative framework and we can expect, or at least hope for, further outcomes and concrete action to fight diabetes.

I want to talk about Bill C-237 sponsored by the member for Brampton South by quoting from subclause 2(2) and speaking about the concerns that the bill addresses. Paragraph 2(2)(a) states that the national framework must include measures to “explain what diabetes and prediabetes are”. It is important to know this and, as MPs, the bill informs us.

I would like to provide some statistics. Diabetes affects 11 million Canadians. Diabetes Quebec estimates that in Quebec alone, roughly 880,000 people have diabetes, and a quarter of a million do not even realize it. They are living with diabetes without knowing it.

Every day, about 20 Canadians die of complications from diabetes. Diabetes is responsible for roughly 25% of heart operations, 40% of kidney failure, and 50% of non-traumatic limb amputations, even today.

For Canadians with diabetes, the risk of getting seriously ill from COVID-19 is twice as high, and the risk of dying is three times higher than normal. It is often harder to treat people with diabetes for viral infections because of the blood sugar fluctuations this can cause.

This is also about the people affected by diabetes. One in five adolescents with type 1 diabetes also suffers from depression, which is twice as high as the average. This affects people differently than the illness itself. Diabetes is also the primary cause of blindness in adults under 65. Diabetes has a major impact.

Paragraph 2(2)(b) of the bill states that there must be measures to “identify the training, education and guidance needs of health care and other professionals related to the prevention and treatment of diabetes, including clinical practice guidelines”.

The Bloc Québécois position on this is that Bill C-237 must not have an impact on Quebec's jurisdictions. However, we are not against virtue, and I will refer to the principle of the bill, which states that everything must be done in collaboration with the other levels of government, but also with the different stakeholders on the ground.

We hope that this means there will be a better distribution of tasks related not only to diabetes prevention and research, but also to caring for individuals with diabetes.

Paragraph 2(2)(c) of Bill C-237 states that the bill aims to “promote research and improve data collection on diabetes prevention and treatment”. Just today, we adopted Motion No. 38, which calls for the creation of a standing committee on science and research. We expect that this issue will be of interest to the committee and that it can look into diabetes.

Data collection can be done through the Public Health Agency of Canada, which is a federal entity. It is important to do it because Ms. Hanso of Diabetes Canada mentioned in committee that currently, in Canada, it is difficult to say how many of the people who have been diagnosed with diabetes have type 1 and how many have type 2. Apparently that is not yet clear.

Prevention is especially important, because over 50% of cases of type 2 diabetes are preventable. The importance of prevention in this context is vital.

Paragraph 2(2)(d) of Bill C-237 requires measures to “promote information and knowledge sharing in relation to diabetes prevention and treatment”. In terms of prevention, some things fall specifically under federal jurisdiction, like the labelling of less healthy, sugary products. That is part of disease prevention, and it falls under federal jurisdiction.

As I mentioned earlier, regarding the importance of coordination, that has to be done with the provincial governments or health officials, indigenous groups and other stakeholders, to be sure to avoid any duplication in the services offered and in terms of responsibilities. We have to make sure no one falls through the proverbial cracks.

Paragraph 2(2)(e) of Bill C-237 requires measures to “take into consideration any existing diabetes prevention and treatment frameworks, strategies and best practices, including those that focus on addressing health inequalities”. It is worth taking a moment to discuss the situation of indigenous people. For various reasons, in some communities, the prevalence of type 2 diabetes is four to five times higher than in the general population.

Investments have been made in the past to try to correct this situation, but we can expect a national framework to be more effective, particularly in three areas. In terms of prevention, we must ensure that awareness campaigns on healthy living are conducted in the communities. We also need better screening to ensure that residents of indigenous communities who have diabetes without realizing it can receive treatment quickly and avoid complications. It is also important to ensure that the treatments adhere to the guidelines and that a consistent approach is taken in order to reduce mortality and comorbidity, since this is a matter that may fall under federal jurisdiction.

Paragraph 2(2)(f) of Bill C-237 reads as follows:

ensure that the Canada Revenue Agency is administering the disability tax credit fairly and that the credit, in order to achieve its purposes, is designed to help as many persons with diabetes as possible.

As we know, the expenses associated with diabetes are very high. It can cost people with diabetes more than $1,500 per year. It has been reported that 30% of Canadians with diabetes cannot follow prescribed treatments because of the cost. These aspects speak to the relevance of Bill C-237.

Bills like this remind us that it is important for members to work together. It is nice to see something other than what happens during question period, to remind us that we can achieve a great deal when we work together. It also gives us the opportunity to learn more about one another. For instance, I learned that the member for Brampton South is a trained cardiology technologist and worked in health care for 18 years. I saw how much she cares about this issue.

In closing, I want to emphasize the wonderful collaboration we have seen on this issue with a quotation from my colleague from Repentigny, who is a member of the all-party diabetes caucus. She often says this in another context, but I think it really applies here: “If you want to go fast, go alone, but if you want to go far, go together”.

I hope that we will be able to go a lot further to tackle diabetes, for we will have done it by working together as parliamentarians.

National Framework for Diabetes ActPrivate Members' Business

May 26th, 2021 / 7 p.m.
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Liberal

Sonia Sidhu Liberal Brampton South, ON

Mr. Speaker, it is an honour to speak in support of my bill today. I want to start by thanking my colleague for Beaches—East York who generously gave up his slot so we could complete debate on this bill.

I also want to thank everyone who supported my private member's bill, Bill C-237, an act to establish a national framework for diabetes in Canada, and all members who contributed to the debate on this bill.

I would especially like to thank the organizations that have helped to support the bill: Diabetes Canada, JDRF, Diabetes Action Canada, the CNIB and many more organizations. I would like to thank researchers, like Dr. Peter Senior from the University of Alberta and Dr. Ken Cloth from St. Michael's Hospital in Toronto, not just for supporting the bill but for the hard work they do fighting diabetes that will some day lead to a cure.

Locally, I would like to thank people like Mayor Brown and the Brampton Council, Mayor Crombie of Mississauga, our Medical Officer of Health, Dr. Lawrence Loh, and the CEO of William Osler Health System, Dr. Naveed Mohammad. They know how important this issue is in our community and across Canada.

I know that when we pass the bill and send it to the Senate it will have just as much support there. I give thanks for the support of senators Marie-Françoise Mégie, Nancy Hartling, Patricia Bovey and many others. With a national framework for diabetes we can introduce a nation-wide effort to prevent, treat and finally end diabetes. If we pass this framework, it will help millions of Canadians living with pre-diabetes or diabetes.

A national framework for diabetes must identify the training, education and best practices of health care and other professionals who treat diabetes. It must improve data collection and promote information and knowledge-sharing in relation to diabetes prevention and treatment. It must take into consideration any existing frameworks, especially those that focus on addressing health inequalities. Finally, it must fund and promote research that will one day lead to a cure.

Last week, I met with Laura from Ottawa west, Nepean. She is a 23-year old who has been living with diabetes type I since she was seven years old. She spoke about how there were early signs. Her teachers and parents did not immediately recognize it for what it was. This is why we need to improve education and awareness so that everyone can recognize the early signs and get treated accordingly.

I also met with Dr. Cathy Felderhof from Cape Breton Island, who told me about the challenges of providing care for rural indigenous people and how diabetes interacts with mental health and other social factors of health. It is so important that experts like her and doctors who treat a variety of patients in the regions across Canada are brought together to help develop this strategy.

Indigenous populations face many factors, including socio-economic factors, that contribute to high rates of diabetes and create barriers to accessing proper treatment. In my city of Brampton, one in six community members has diabetes or pre-diabetes. The COVID-19 pandemic has increased the challenges faced by people living with diabetes who are at an increased risk of developing severe symptoms. Economic insecurity, lack of physical activity and struggles with mental health during this pandemic have all had a negative impact on those living with diabetes.

Treating diabetes is expected to cost the health care system in Canada almost $40 billion by 2028. This projected cost is concerning and it could be reduced if we pass Bill C-237 into law. A national framework for diabetes would provide guidelines to address diabetes and invest in prevention and education about the disease and in data collection. With this framework, we can see valuable input from stakeholders such as Diabetes Canada, JDRF and programs such as Diabetes 360°. This year, we are celebrating the 100th anniversary of the discovery of insulin at the University of Toronto by Sir Frederick Banting and his colleagues. Canada gave insulin to the world. It is time for Canada to once again lead the way in the fight against diabetes.

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11 a.m.
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Liberal

Sonia Sidhu Liberal Brampton South, ON

moved that the bill be read the third time and passed.

Mr. Speaker, it is an honour to speak on my private member's bill, Bill C-237, an act to establish a national framework for diabetes in Canada.

I want to begin by thanking the member for Marc-Aurèle-Fortin, who generously traded his slot so we could begin third reading on this bill today. I would also like to thank all my colleagues in the Standing Committee on Health who unanimously supported this bill in March.

As members of this House know, 2021 is the year we are celebrating the 100th anniversary of the discovery of insulin by Sir Frederick Banting and his colleagues at the University of Toronto. This is still recognized as one of the greatest achievements of medicine in the 20th century and made them the first Canadians to win a Nobel Prize. It has been inspiring to see how the world has recognized this monumental achievement.

On April 14, the University of Toronto hosted 100 years of insulin symposium, which drew more than 6,000 attendees from around the world. This was also the occasion where Canada Post chose to unveil a new stamp that features a quote from Banting's unpublished journal, in his own handwriting, as well as the original insulin bottle with a red cap. I was proud to advocate for the creation of a stamp like this, as it serves both as a celebration of the achievement and as a reminder that the search for a cure continues.

On the same day, the Minister of Health opened the World Health Organization's summit to launch a Global Diabetes Compact, which seeks to improve the diagnosis rate and care for people living with diabetes. She highlighted this bill and said:

Canada has a proud history of diabetes research and innovation. From the discovery of insulin in 1921 to one hundred years later, we continue working to support people living with diabetes. But we cannot take on diabetes alone. We must each share knowledge and foster international collaboration to help people with diabetes live longer, healthier lives — in Canada and around the world.

The director general of the WHO said:

The number of people with diabetes has quadrupled in the last 40 years. It is the only major noncommunicable disease for which the risk of dying early is going up, rather than down. ...The Global Diabetes Compact will help to catalyze political commitment for action to increase the accessibility and affordability of life-saving medicines for diabetes and also for its prevention and diagnosis.

This is why now is the time for all levels of government in Canada to work with stakeholders and create our own strategy to fight and ultimately end this disease, one that coordinates funding for awareness, prevention, education, data collection, treatment and research that will improve health outcomes for all Canadians and one day lead to a cure.

Diabetes rates are three times to four times higher among first nations than among the general Canadian population. Furthermore, indigenous individuals are diagnosed with type 2 diabetes at a younger age than other individuals.

In my own community of Brampton, every sixth resident has diabetes or prediabetes. The COVID-19 pandemic has increased the challenges faced by people living with diabetes, who are at an increased risk of developing severe symptoms and dying from this infectious disease. Furthermore, the economic insecurity, lack of physical activity and mental health struggles associated with the pandemic all have a negative impact on those living with diabetes.

A national framework for diabetes would provide a common direction for all stakeholders to address diabetes and other chronic diseases with the same common risk factors. It would enhance coordinated efforts across federal, provincial and territorial jurisdictions and provide a mechanism for tracking and reporting on progress.

The government needs to conduct its own consultation and stakeholder engagement. However, one proposed strategy that could be taken into consideration for the national framework, and which has been considered by the health committee, is diabetes 360°. This was developed in collaboration with more than 120 stakeholders and has strong support not only from the entire diabetes community but also from other key health stakeholders.

I would like to thank all the individuals and organizations that have supported this bill and helped it come together. That support means a lot to me and I know it will make a difference in the lives of 11 million Canadians living with diabetes or prediabetes.

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 now it is time for more than awareness. It is time for action. Canada, 100 years ago, made the biggest leap in the treatment of diabetes.

Let us pass Bill C-237 today and send it to the Senate. I am very hopeful that passing this bill will help millions of Canadians who are fighting this disease. Canada gave insulin to the world. Why can we not lead the way?

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:05 a.m.
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Conservative

Marilyn Gladu Conservative Sarnia—Lambton, ON

Madam Speaker, I would like to thank the member for Brampton South for all of her advocacy on diabetes all these years and for a great speech today.

Beyond the national framework that is definitely needed, there are other things the government could do. The member mentioned a 360° Canada plan. Diabetes Canada has been asking for $150 million of funding from the federal government for a number of years and it has not been funded. Also, the pharmacare the Liberals have been talking about has not been brought forward and there are many people who cannot afford to buy their diabetes medications.

Can the member say whether the Liberal government will support those two things?

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:10 a.m.
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Liberal

Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, I would like to thank the member, who I serve with on the health committee, for her leadership. The government, of course, needs to conduct its own consultation and engage stakeholders. Diabetes Canada has done great work in putting together its 360° strategy. I hope the minister will take this work into consideration when crafting an official framework, as well as the other testimony and recommendations found in our HESA report. She was in the committee when we did the HESA report. It was a great report.

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:10 a.m.
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Bloc

Louise Chabot Bloc Thérèse-De Blainville, QC

Madam Speaker, we have to applaud our colleague's hard work and dedication with respect to this important disease.

Each of our provinces has an association, and Diabetes Québec is doing great work in Quebec.

What does my colleague think of the purpose and scope of this national strategy given that this is a provincial responsibility?

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:10 a.m.
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Liberal

Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, I would like to thank the Diabetes Québec association. While I recognize my colleague's interest in creating health transfers to the provinces, during the pandemic the federal government has been there to support that. This includes over $19 billion in the safe restart agreement. It was announced that an additional $4 billion would be given to the provinces through the Canada health transfer and another $1 billion to help with the vaccine rollout. We have stepped up to help all provinces, including Quebec. We will work Diabetes Québec and all provinces. As I said in my bill, we will work with the Diabetes Québec association, provinces and territories—

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:10 a.m.
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NDP

Rachel Blaney NDP North Island—Powell River, BC

Madam Speaker, I want to thank the member for bringing forward this private member's bill on this really important issue. Not too long ago, before COVID, I had two young people come and speak to me about juvenile diabetes. One of the biggest challenges was that in one province, all of the things they required were free and part of the program, but in another province they were not. We had outcomes of health that were completely different simply because of the province people were born in.

Does the member agree that diabetes-related medications, supplies and equipment should be included as part of a universal, comprehensive and public pharmacare program?

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:10 a.m.
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Liberal

Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, I would like to thank the member for sharing her story and for her advocacy. I agree that no Canadian should have to choose between paying for prescription medication and necessities, like rent or putting food on the table. I would like to remind the member that since taking office, this government has taken historic action to lower drug prices, including by introducing new rules for patent drugs so Canadians can buy their medicine easily. We need to do a lot more. I thank the member for sharing her story and for her advocacy for her constituents. We will work together to pass this bill—

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:10 a.m.
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Central Nova Nova Scotia

Liberal

Sean Fraser LiberalParliamentary Secretary to the Deputy Prime Minister and Minister of Finance and to the Minister of Middle Class Prosperity and Associate Minister of Finance

Madam Speaker, I want to start by thanking my colleague for championing the issue of support for families and individuals with diabetes since I have known her, when we were both elected in 2015.

The families I speak with talk often about the serious burden that exists to manage diabetes for themselves or their children, but we do not often hear about the importance from an economic point of view, given the immense cost of diabetes across the health care systems in Canada. I wonder if the hon. member can offer comment not only on the importance of doing this because it is the right thing to do to support people and families, but also the fact that it is the smart thing to do to alleviate the immense burden that lack of proper diabetes care puts on our health care systems.

National Framework for Diabetes ActPrivate Members' Business

May 3rd, 2021 / 11:15 a.m.
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Liberal

Sonia Sidhu Liberal Brampton South, ON

Madam Speaker, I would like to congratulate the member on the great work in the budget regarding diabetes. I am so thankful. I know this is very important because it is a big burden on the health care system, as we know through the Diabetes Canada website, with $40 billion until 2026. This budget is a recovery plan for job growth and resilience, to finish the fight against COVID-19 to ensure that we—