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, an excellent resource from 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

November 27th, 2020 / 2:25 p.m.
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Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

November 27th, 2020 / 2:30 p.m.
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Liberal

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11 a.m.
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Winnipeg North Manitoba

Liberal

Kevin Lamoureux LiberalParliamentary Secretary to the President of the Queen’s Privy Council for Canada and to the Leader of the Government in the House of Commons

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

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

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

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

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

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

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

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

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11:10 a.m.
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Conservative

Tom Kmiec Conservative Calgary Shepard, AB

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11:20 a.m.
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Bloc

Sébastien Lemire Bloc Abitibi—Témiscamingue, QC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11:25 a.m.
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NDP

The Assistant Deputy Speaker NDP Carol Hughes

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11:25 a.m.
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NDP

Brian Masse NDP Windsor West, ON

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11:35 a.m.
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Oakville North—Burlington Ontario

Liberal

Pam Damoff LiberalParliamentary Secretary to the Minister of Indigenous Services

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11:45 a.m.
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Conservative

Ted Falk Conservative Provencher, MB

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / 11:55 a.m.
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Liberal

Sonia Sidhu Liberal Brampton South, ON

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

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

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

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

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

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

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

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

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / noon
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NDP

The Assistant Deputy Speaker NDP Carol Hughes

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

The question is on the motion.

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

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / noon
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Liberal

Mark Gerretsen Liberal Kingston and the Islands, ON

Madam Speaker, I request a recorded division.

National Framework for Diabetes ActPrivate Members' Business

March 8th, 2021 / noon
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NDP

The Assistant Deputy Speaker NDP Carol Hughes

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