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.
Sonia Sidhu Liberal
Introduced as a private member’s bill.
This bill has received Royal Assent and is now law.
This is from the published bill.
This enactment provides for the development of a national framework designed to support improved access for Canadians to diabetes prevention and treatment.
All sorts of information on this bill is available at LEGISinfo, an excellent resource from the Library of Parliament. You can also read the full text of the bill.
The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes
We will go to a very short question from the hon. Parliamentary Secretary to the Minister of Finance.
National Framework for Diabetes ActPrivate Members' Business
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.
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—
The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes
Resuming debate, the hon. member for Sarnia—Lambton.
Marilyn Gladu Conservative Sarnia—Lambton, ON
Madam Speaker, it is a pleasure to rise and speak to Bill C-237, the national framework for diabetes act.
I would like to thank the member for Brampton South for bringing it forward and for all her advocacy. From the time we were both elected in 2015, I have participated alongside her. We were both on the health committee when it came up with recommendations to the government on what it should do about diabetes. It is a serious issue for 11 million Canadians who have diabetes or prediabetes. That report was important.
The hon. member has also done numerous other things to raise awareness of diabetes on the Hill. I can remember an event for all the MPs to get tested, to understand how they could see the risk factors for diabetes and find out whether or not they actually had prediabetes or diabetes. That was great. There was another time when we brought in a mobile unit that had the ability to test and treat. These mobile units are very important here in Canada, especially in rural and remote places where, in many cases, it is very difficult to get access to a physician and the medical care that is so important to people who are living with diabetes.
For that, I congratulate the member. I am happy to see this bill being supported unanimously at committee, along with the support for the amendment that the Conservatives brought forward.
For those who are not aware of the different types of diabetes, 11 million Canadians have diabetes or prediabetes. Type 1 diabetics are people who cannot produce insulin, and there are 1.1 million of them. In order to get the insulin they need, they need to either inject it or use insulin pumps, a new technology that has really upgraded the quality of life for individuals. However, those pumps are $7,000 or $8,000, so affordability is a key issue there.
The most common type of diabetes is type 2. These individuals cannot use the insulin they are producing, or they are not producing enough insulin, and there are 9.9 million Canadians in this category. There are things that can lessen the risk of developing type 2 diabetes, including healthy eating and regular exercise. However, once people have this condition, they are going to require insulin therapy, medications and sometimes glucose monitoring. There have been good advances in the technology of glucose monitoring that have really improved the quality of life. Again, there is an affordability issue for some.
Canada began this 100 years ago, with Banting and Best and insulin, and we have continued to excel in technology in this area.
The bill itself is a national framework, and as part of that it is going to bring prevention and treatment. There will be training and an emphasis on educational needs, which I think is important. The more people know about diabetes, the risks and how they can prevent or minimize the impact, the better. There is also an important part on research and data collection. The government, over decades, has done excellent work to support diabetes research in Canada, and that needs to continue, along with the data collection.
The other part of the bill is information and knowledge sharing, related to preventing and treating diabetes. This will be important because this is a disease that can develop into other complicated conditions. Kidney disease is a common outcome for those who are at risk and who cannot control their insulin levels. Many have foot and leg problems that can result in amputation. There are eye diseases, and increase in heart attack and stroke. All of these issues are not just tragic for the individual, but also a cost to the health care system.
The parliamentary secretary previously made a comment that bringing in this national framework is not just the right thing to do, but it is also a cost-benefit. We know that if diabetes is not adequately controlled in an individual, an emergency room call is $1,500 and an amputation is $90,000. All of these things are incredibly costly to the health care system.
Although some concerns have been raised about whether or not the bill will be a problem with provincial jurisdiction, I would say that the provinces absolutely are open to receiving more federal funding to cover things and to do the right thing to prevent more expensive conditions from developing.
In fact, my own national framework on palliative care is a great example of how the federal government can work alongside the provinces to provide the supplemental things that do not exist at the provincial level and to have the provinces use their funding to accelerate the plan. With the palliative care framework, many things related to education, research and data collection, as in this bill, were put in place, but then the provinces also came alongside with money for hospice and for training paramedics and extending all kinds of things that have resulted in more people having access. My hope is that we will see the same thing with this bill. It is important.
The amendment that the Conservatives brought had to do with the disability tax credit. Members may remember that a few years ago there was a change made by CRA and 80% of people who previously were approved for the disability tax credit, which helps people pay for the medications and supplies they need as people living with diabetes, now became 80% rejected, and it was a long period of time of outcry from the opposition parties before the government set that right.
To be fair, the intent of the government was that if people were not eligible for the tax credit, they also were not eligible for the disability pension plan. That plan had been in effect for 10 years, and each individual who qualified had about $150,000 in the account, so there was a bit of a nefarious attempt to try to take that money away, which fortunately we were able to correct and get that in place.
Our amendment was to make sure that the CRA is administering the disability tax credit fairly and that the disability tax credit is designed to help as many persons with diabetes as possible and is achieving its objectives. This will provide a bit of oversight to ensure that this kind of thing does not happen again, and that will be very important.
What the bill does not do is provide some of the other funding that will be needed, and some of it has been talked about already. Diabetes Canada does an amazing job of making people aware, helping people living with diabetes, and providing tools and training, but it has a 360° initiative, calling on the federal government for quite a number of years, from the time I was the shadow health minister, and it has not been funded at any point. We need to see the government seriously consider, with 11 million Canadians living with this condition, that we have to be preventive in nature.
There are a lot of initiatives that also could be supported, like Participaction, getting people more fit. If we can get children more fit and eating more nutritiously, this is a key factor in preventing people from having type 2 diabetes, so that is an action that the government could take.
When it comes to pharmacare, the Liberals have been talking about this since 1992. Many provinces have plans already in place, and there is a very small number of Canadians who do not have coverage, but in particular there are people with diabetes who are not able to afford their medications. It is a larger cost to the system overall and something that should be addressed and could be quickly addressed through organizations like Diabetes Canada.
In terms of this framework, obviously I am a passionate advocate as well for eliminating diabetes and doing everything we can to help those individuals. I, as well as the Conservative Party, will be supporting this private member's bill. The member is to be commended for her continued advocacy and for her persistence in bringing more and more good ideas to the table. We can see from the reaction of the various parties that everyone wants to work together, alongside the provinces and territories and our indigenous organizations, to make sure that all people living with diabetes receive the help they need.
Monique Pauzé Bloc Repentigny, QC
Madam Speaker, some diseases quietly besiege their victims and can eventually compromise their health and threaten their very survival.
Diabetes is one such disease. More and more people are aware of diabetes because a growing number of Canadians and Quebeckers are being diagnosed with it. Personally, the disease has not affected me or any of my family members or friends.
However, in my work as the member of Parliament for Repentigny, I met Juliette Benoît for the first time in October 2018. Juliette was 13, and she came to Parliament Hill to raise parliamentarians' awareness of a disease that tends to be poorly understood by the general public, type 1 diabetes. This disease generally appears in young people under 20 and is characterized by the total absence of insulin production. People with this type of diabetes must have daily insulin injections or be fitted with an insulin pump to survive. Like Juliette, approximately 10% of people with diabetes have type 1 diabetes.
This young girl captured my attention the moment I met her. A few words that come to mind when I think of her are eloquent, precise, determined and brave. She wants to help advance the research on a potentially life-threatening disease that she has had since she was 11 years old. That is why she got involved in the Juvenile Diabetes Research Foundation, which could not ask for a better ambassador.
I have to say that it is because of Juliette Benoît that I am currently a member of the all-party juvenile diabetes caucus. Juliette took a personal problem and used it as an opportunity to shine the light on a disease that affects nearly 300,000 people in Canada. She convinced me to get more involved in this cause and she used her disease to become a force for change. That is wonderful to see.
I thank the member for Brampton South for introducing Bill C-237, which seeks to establish a national framework for diabetes. Section 2 of the bill explains that the national framework must include measures to:
(a) explain what diabetes and prediabetes are;
(b) 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;
(c) promote research and improve data collection on diabetes prevention and treatment;
(d) promote information and knowledge sharing in relation to diabetes prevention and treatment;
(e) take into consideration any existing diabetes prevention and treatment frameworks, strategies and best practices, including those that focus on addressing health inequalities; and
(f) 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.
Bill C-237 gives the government one year to develop the strategic framework and five years to report on its effectiveness. 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, because that matters to us. Certain aspects of clause 2 fall under the jurisdiction of Quebec and the provinces.
I already mentioned Juliette, who is living with type 1 diabetes, and now I would like to talk briefly about the two other kinds of diabetes, type 2 and gestational diabetes.
In Canada in 2020, of the more than 3.7 million diagnosed cases of type 1 and type 2 diabetes combined, 90% were type 2. This type of diabetes usually appears in adulthood, in individuals 40 years of age and older. Because of rising obesity rates, diabetes is starting to appear in increasingly younger populations, sometimes as early as childhood in certain risk groups. People with type 2 diabetes cannot properly use the insulin made by their bodies, and they eventually produce less and less of this essential hormone.
Between 3% and 20% of pregnant women experience an increase in blood glucose levels beginning in the second or third trimester of pregnancy. In most cases, this gestational diabetes disappears after the birth, but the mother is at risk of developing type 2 diabetes in the years that follow.
It goes without saying that women should be monitored properly in the months and years after they give birth. That being said, we can all agree that this bill provides a framework that proposes objectives, actions and ambitions that have already been broadly discussed in several specialized forums, including the annual meetings of doctors who specialize in endocrinology and pediatric endocrinology. Seminars, symposiums and research institutes also investigate this sometimes misunderstood and long-stigmatized disease, which may affect more than 13.5 million Canadian citizens in 2030.
Canada is the birthplace of the discovery of insulin. This year marks the 100th anniversary of that discovery, and it is to Canada's credit that it is allocating resources to the advancement of research into diabetes, among other things. This is precisely where the government should be providing support, in addition to increasing transfers, of course.
Research into diabetes and medical treatment for it are advancing quickly. Note that the fact that there are five different types of diabetes has eluded researchers until very recently. In 2019, the renowned scientific journal The Lancet Diabetes & Endocrinology published this finding, made by a team of Scandinavian researchers. Having looked at cases characterized as atypical, these researchers are better prepared to prevent the onset of the disease and better treat people who develop it.
Also in 2019, American scientists in California grew insulin-producing cells in a laboratory. They describe their work as a major breakthrough that could lead to a cure for type 1 diabetes. I invite interested colleagues to read the journal Nature Cell Biology to learn about the science that could lead to a cure for insulin-dependent diabetes within a few years.
The prevalence of this disease is alarming, especially with children developing type 2 diabetes, which used to affect only adults, so the need for research will grow. Every aggravating factor leading to the development of diabetes should be meticulously studied, because not only will the health and social costs be enormous, but the direct costs to the health care system could reach almost $5 billion Canadian by 2030. This was a question asked earlier by the Parliamentary Secretary to the Minister of Finance. We may not have the same figures, as the member for Brampton South had a different figure, but it is important to remember that a great deal of money could be directed to other issues if we could find a cure for diabetes.
I spoke about Juliette at the beginning of my speech. What is she doing now, three years after our first meeting? She continues her advocacy with the Juvenile Diabetes Research Foundation. Last November, she participated in Kids for a Cure Lobby Day and shared her personal story with some MPs. She was surprised to see just how young some MPs are. Several are in their thirties, and some are even in their twenties. I believe that she is considering getting into politics. She is ambitious, disciplined and has everything it takes to make the world a better place. I thank her for talking to me about her hopes of making a difference for people with diabetes.
Rachel Blaney NDP North Island—Powell River, BC
Madam Speaker, I am incredibly pleased to be here today to speak on Bill C-237, an act to establish a national framework for diabetes.
This is an incredibly important private member's bill, because it addresses something that really concerns me: The reality that people with diabetes across Canada are being treated very differently depending on what province or territory they live in. I thank the member for bringing this bill forward and for her passion on this very important issue. I am very happy to be here to discuss why it is important.
A couple of years ago, Juvenile Diabetes spokespersons came to have a conversation with me. I met with two teenagers, one from Alberta and one from British Columbia. As members in the House, we all have moments where we hear stories and think, “This is wrong,” and that we have do something to make it better. That day, I learned that people living with diabetes could have something inserted in their arms that would allow them to scan their blood sugar levels very quickly with their phones. There was no more need for pricking fingers or carrying around those tools: They could quickly scan to see how things were going and address them as needed. The problem is that in one teen's province, there is a monthly fee for this service, and in the other teen's province, there is no fee at all.
It really broke my heart when I heard from the mother of the teen who was in the province where a monthly fee was required. She and her husband had been doing really well paying that monthly fee, until her husband got hurt on the job and was off work. Their income went down significantly. The mother told me that one of the hardest choices they had to make was to acknowledge that they could no longer afford the monthly fee, which meant that their daughter had to have the pump removed and move forward.
No parent ever wants to do that. It completely broke my heart. I do not think any parent in the country would be happy if they had to make a decision between the health and well-being of their child and feeding them. I recognize that across Canada, many parents have children who have health issues. They really struggle to afford, or cannot afford, the basic medication they need to make sure that their children are well cared for, and this is one example. We need a better strategy. It is important to point out that a national pharmacare program would address this issue and ensure that parents would not be making choices, such as these parents had to, between their children's health and well-being and feeding them and keeping a roof over their heads.
The facts are very clear. Individuals with diabetes cannot regulate their blood sugar properly. Diabetes causes many physical health issues, and is a cause of debt for more than 7,000 Canadians every year. Diabetes also impacts the mental health of people who have diabetes, as well as their families. It is time for Canada to take this seriously, and the bill before us is one step towards doing so.
This bill asks the government to bring together all provinces, territories, indigenous leaders and stakeholder groups to create a plan to support those living with diabetes more holistically. Diabetes is a chronic disease, and it is so important that the federal government do more to support Canadians living with diabetes, particularly those who incur significant out-of-pocket costs because of it. Too many Canadians living with diabetes are unable to afford the medications, devices and supplies they need. When medication and supplies are unaffordable it leads to bigger health issues, which can lead to an early death. That is just not acceptable in a country as wealthy as ours. Families and loved ones feel this reality, and it is really scary for them to always worry about what they will do if they cannot afford what those people need.
Not too long ago, I received a message from a constituent who had just been diagnosed with diabetes, and she was really scared. She was not sure how she would afford the medication. When dealing with a chronic illness, the last thing the body needs is the stress of wondering, “Can I afford the most basic supplies and medication that I need?” We know that this is true. 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 their medications, devices and supplies.
Fifty-seven per cent is more than half of Canadians who have this chronic disease. This is important because research indicates that when a chronic illness is managed, the expense is lower and the health of the individual increases. Preventative supports matter. They allow people to care of themselves and prevent repetitive visits to the emergency room caused by a lack of access to medications, devices and supplies.
Again, we have to think about what this means in Canada. It is one of the most wealthiest countries in the world and these realities exist because people cannot afford their medication.
This is why Canada's New Democrats recognize that there is an urgent need to for universal, comprehensive and public pharmacare, a plan to ensure that all Canadians have access to the medications they need when they need them, that we do not have people like my constituents staying up half the night wondering how they will afford this new expense in their lives. This must include coverage for diabetes devices and supplies, such as test strips, syringes, insulin pumps and continuous glucose monitors.
Sadly, we have seen the reality that the Liberals and the Conservative governments, one after another, continue to deny this measure that would create a more affordable and a fair system to care for the well-being of people across Canada. It would save significant money by lessening emergency health care costs, which are extremely high and terrible for the health of people who cannot afford their medication. Universal health care would also support businesses that have multiple challenges when they have a team member or a loved one who has health issues. In some cases, even with health insurance people cannot afford the cost of their medication.
Just weeks ago we heard the government make promises, but when it actually had an opportunity to support pharmacare, it said no. How many times do Canadians have to wait and ask again for this human rights-based approach?
I will be supporting this bill. It is a step that will at least support people living with diabetes. I hope the government will support it as well. The concerning reality is that so many families that apply for the disability tax credit when they have children who are born with diabetes lose it when those children come into adulthood. The Government of Canada has rejected these applicants in the past. When is in place, I hope it stops denying this small tax credit. Most important, ensuring that people have access to the RRSPs they invested in for many years is absolutely key for me.
There is a lot of injustice for people living with chronic illness. I hope the bill will at least help one portion of the community. However, I want to remind everyone in the House that only pharmacare will make it a more fair system for everyone in the country.
National Framework for Diabetes ActPrivate Members' Business
Winnipeg North Manitoba
Liberal
Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and Minister of Intergovernmental Affairs and to the Leader of the Government in the House of Commons
Madam Speaker, it is a pleasure to speak to Bill C-237, an act to establish a national framework for diabetes. Once again, I applaud my colleague and friend from Brampton South who has been a staunch advocate for such an important issue that affects millions of Canadians.
Having a national framework for diabetes is long overdue. I want to take the time, first and foremost, to recognize the need. It is important to note the impact diabetes has on the health of over three million people in Canada. Including Canadians who are prediabetic, that number is closer to 10 million-plus, keeping in mind our population of 37.5 million people today.
As a government, we continue working with our partners, including provinces and territories, indigenous organizations, stakeholders and organizations such as Diabetes Canada, to strengthen the efforts that support diabetes prevention and care for all Canadians. For me, it is about prevention and treatment, and there is so much we can do.
I have had the opportunity to speak on this before. I want to emphasize Diabetes Canada and the fantastic work it does. In fact, people can get all the relevant information they need from it, not to mention all the things they can do to improve the quality of their lives or, in some cases, minimize the negative impacts diabetes has on people through healthy living and so forth. If they go to diabetes.ca, there is ample information.
From my perspective, Diabetes Canada clearly shows leadership. As a national organization, it can assist regional organizations. My colleague has hit this right on, that there is a need for a national perspective, a national framework designed to support and improve Canadians' access to information on diabetes prevention and treatment. This bill is all about that. It is about working with provinces and territories, indigenous leaders, communities, different stakeholders, bringing them together and making a real difference. I am hopeful that we can pass the bill.
There are two types of diabetes, and I got this information from the diabetes.ca website, which contains quality of information. Type 1 diabetes is an autoimmune disease and is also known as an insulin-dependent diabetes. People with type 1 diabetes are not able to produce their own insulin and cannot regulate their blood sugar because their body is attacking the pancreas. The website states:
Roughly 10 per cent of people living with diabetes have type 1, insulin-dependent diabetes. Type 1 diabetes generally develops in childhood or adolescence, but can also develop in adulthood. People with type 1 need to inject insulin or use an insulin pump to ensure their bodies have the right amount of insulin.
There is so much we can be doing from a national perspective by encouraging, promoting and supporting, in whatever ways we can, a national strategy.
I commend my colleague from Brampton and those individuals who were there to support her initiative to bring the bill to the floor of the House of Commons. I trust and hope that my colleagues on all sides of the House will see fit to pass this bill as soon as possible, maybe even today.
Len Webber Conservative Calgary Confederation, AB
Madam Speaker, it is my pleasure to speak today to Bill C-237, which proposes a national framework for diabetes.
The bill has been brought forward by our colleague, the member for Brampton South, and I would like to take a moment to comment on her dedication to seeing this bill passed and her overall concern for the health of Canadians.
The member, who I served with for many years on the health committee, has always been one of the most non-partisan and collegial members of the committee. Her sincere desire to improve health outcomes for Canadians has always been her underlying motivation, and it has been an absolute pleasure to work with her on that committee.
The situation with diabetes in Canada is truly shocking. About three million Canadians live with diabetes. One in three children and one in 10 adults live with the disease. People with diabetes are over three times more likely to be hospitalized with cardiovascular disease, 12 times more likely to be hospitalized with end-stage renal disease and almost 20 times more likely to be hospitalized for non-traumatic lower limb amputation compared to the general population. Diabetes contributes to 30% of strokes, 40% of heart attacks, 50% of kidney failure requiring dialysis, 70% of all non-traumatic leg and foot amputations and is leading the cause of blindness in Canada.
The direct cost to our health care system just last year was $3.8 billion. It is estimated to rise to about $5 billion by 2030. That is a huge weight on our health care system.
There is no doubt that diabetes is a serious chronic disease and it is on the rise. It is a disease that occurs when the body is either unable to sufficiently produce or properly use insulin. Over time, left untreated, it can damage blood vessels, nerves and organs such kidneys, eyes and heart, resulting in the serious complications that I mentioned, and ultimately death. It poses a challenge not only to those living with the disease, but also to their families, communities and the health care system. Therefore, any investment in reducing the rate of diabetes in our country should translate into long-term savings to our health care system. It just makes senses that we deal with this issue head on and deal with it now.
Also, each year close to 200,000 Canadians are newly diagnosed and many more diagnosed as prediabetic. Not all individuals with prediabetes will develop diabetes, but the chances increase if steps are not taken to manage it. Fortunately, recent studies have shown that changes in lifestyle, primarily diet, physical activity and weight management, can delay or even halt the progression. However, there is no question that we need to look at diabetes as a national problem and come up with a national framework, which Bill C-237 proposes.
The aging of the Canadian population, largely a result of baby boom cohort, has been one of the major factors contributing to the increase in the number of Canadians living with diagnosed diabetes. The increasing incidence is shocking. If any other health issue like cancer had increased in comparison, we would declare a national emergency and pull every fire alarm. Why do we not do it in this case? I believe it is because of the ongoing and unfair stigma that those with diabetes are simply lazy, unhealthy and authors of their own problems, which is simply not the case.
Diabetes is complex and the people affected by it are not always in full control of their health conditions. We need to stop thinking that this is entirely a lack of personal health. At the same time, we should also not underestimate the importance of maintaining a healthy weight and lifestyle.
As part of any national framework on addressing diabetes, it is critically important that we look at the issue of organ donation. I know the member for Brampton South is also very supportive of organ donation and improving our system in Canada.
Diabetes, at its root, is a malfunctioning pancreas that fails to make the necessary amounts of insulin at the right time. For type 1 diabetes, there is some hope people could receive a pancreas and/or a kidney transplant. A transplant can cure this problem and eliminate the need for insulin shots, but we need more people to donate these life-saving organs.
For those who undergo a pancreas transplant, the survival rate exceeds 95% after one year and more than 88% after the five-year mark. It is possible to be a living donor and donate a pancreas, but this is rare and most donations come from deceased donors. Typically, these transplants last 10 to 12 years, so unfortunately multiple transplants and multiple donors are required over time.
When it comes to kidney donations, the situation in Canada is quite dire, with more than 3,300 people on the waiting list. The demand is high because kidney transplants are in need for more than just diabetics. The wait time can range from months to years. Many never get their second chance at life.
The good news is that people can be living kidney donors. They can donate one of their kidneys to save another. I admire the member for Edmonton Manning, who did so for his son. Of course, live donations are a complex process and are required because we do not have enough deceased donors.
The point is this: Canadians can dramatically improve the life and health of type 1 diabetics by becoming organ donors, so I strongly encourage all Canadians to register on their provincial organ donation registries and let their loved ones know of their decision.
Sadly, a pancreas transplant is not really an option for those with type 2 diabetes because that type of diabetes occurs when the body generates a resistance to insulin or is unable to utilize it properly. Type 1 diabetics make up about 10% of those with diabetes. Their bodies just do not make insulin, which is a situation where a pancreatic transplant would be required.
A constituent of mine, Brooklyn Rhead, a grade 12 student at St. Francis High School, was diagnosed with type 1 diabetes in February of last year. She suffered severe symptoms for about a year before her diagnosis. Her symptoms included extreme thirst, hair loss, fatigue, inability to concentrate and weight loss.
As part of Brooklyn's efforts, she has set out to increase awareness of type 1 diabetes and to raise $5,000 for diabetes research at her high school. So far, she has raised $3,900. I am confident that she will reach her goal, so I applaud her. More than 300,000 Canadians have type 1 diabetes, and Brooklyn's efforts are creating awareness. It is an important contribution to finding the answers.
Many are desperately longing for a cure. We know there is a need for a cure. We know there is political will. We know the need is urgent. We know the need is growing. As Parliamentarians, we need to move this bill along as quickly as possible to make that difference.
From my own personal experience, I have seen excellent pieces of legislation die when an election is called, so I hope we can get this to the Senate and get it passed as soon as possible before a writ is possibly dropped. Brooklyn and three million other Canadians are watching. They are counting on us to get the job done, so let us get it done.
Tony Baldinelli Conservative Niagara Falls, ON
Madam Speaker, it is my pleasure to rise today to speak to this bill. Bill C-237, the national framework for diabetes act, would direct the Minister of Health to develop a national framework to support diabetes prevention and treatment in consultation with relevant stakeholders. That is a key aspect of what this bill talks about. It would require the Minister of Health to hold at least one conference with relevant stakeholders to develop the described framework.
As we talk about stakeholders, it is my pleasure to stand in my place today to share with the House the advocacy efforts and work of one of my own constituents, Maya Webster. Maya is 10 years old, and she will continue advocating for type 1 diabetes research until a cure is discovered.
This past November, Maya took part in a lobby effort with more than 30 other delegates as part of the Juvenile Diabetes Research Foundation's Kids for a Cure Lobby Day 2020. JDRF is a global charitable organization with the goal of ending type 1 diabetes through research funding and advocacy. Kids for a Cure 2020 was a week-long virtual event that connected youth delegates with Canada's decision-makers and politicians. They were able to illustrate the daily challenges faced by people living with type 1 diabetes and to ask for more direct support from the government.
The foundation had three main asks during that lobby effort. They asked for the federal government to renew a partnership with JDRF and the Canadian Institutes of Health and Research, and for the federal government to create a national diabetes strategy, which is why we are here today. They also asked for more people to be able to access the disability tax credit. As Maya explains, “What I'm doing this year, and what I did in 2018 with this, is trying to find the cure because as much as I have insulin it still isn't a cure”.
As part of their consultation, delegates created virtual slide shows to give personal overviews of what living—
The Assistant Deputy Speaker (Mrs. Alexandra Mendès) Alexandra Mendes
The hon. member will have eight minutes to continue his speech when we next return to the reading of this bill.
The time provided for consideration of Private Members' Business has now expired. The order is dropped to the bottom of the order of precedence on the Order Paper.
The House resumed from May 3 consideration of the motion that Bill C-237, An Act to establish a national framework for diabetes, be read the third time and passed.
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—
The Deputy Speaker Bruce Stanton
Order.
Unfortunately, the member's time is up.
Resuming debate. The hon. member for London—Fanshawe.
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.”