Bill C-237 (Historical)

National Framework for Diabetes Act

An Act to establish a national framework for diabetes

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

Financial Statement of Minister of Finance

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I rise in the House today to discuss our government's priorities in budget 2024. I will be splitting my time with the member for Winnipeg South Centre.

In my speech today I want to focus on certain priority areas for my residents in Brampton South that I believe this budget responds well to. As I met with families, businesses and organizations in my riding, I have heard about serious issues and challenges that they wanted their federal government to address. Issues such as addressing auto theft, implementing national pharmacare and supporting our youth, seniors and families are just some of the concerns I have heard from my residents. I am going to highlight some effective advocacy of the members on this side of the House that has helped us achieve important progress and fairness in Brampton and for millions of Canadians.

Let me start with the response to auto theft. I have heard through consultation, as well as on the doorsteps of my residents, that we need to work together with all levels of government to urgently respond to this issue. This is exactly what we are doing.

Hundreds of cars have been stolen. Auto theft is not a victimless crime. It harms thousands of Canadians every year. No one should wake up to discover the car they use to get to work, school or the grocery store has been taken from them. This is why the Liberal government is cracking down on auto theft with a robust plan to make it harder to steal and export vehicles.

Members of the 905 caucus, the auto caucus and the Brampton caucus have also advocated for tougher penalties for the offenders, something we have heard from our local law enforcement. This is why the government is also moving forward with harsher penalties under the Criminal Code for those who commit an auto theft-related offence.

Budget 2024 announces the government's intent to amend the Criminal Code to provide additional tools for law enforcement and prosecutors to address auto theft. New criminal offences will be created related to auto theft, such as possession of an electronic device used to steal cars, and new offences for those who involve youth in their crimes.

Most stolen cars leave our country through the ports, and this is where we are putting our attention. Earlier this year, I attended the national summit on combatting auto theft where we raised the concerns of our residents about making sure we take measures to secure our ports. One of the key resolutions of the summit was the commitment of Transport Canada to work with public safety partners to identify cargo-handling risks through targeted security assessments of port facilities.

CBSA has been an important partner in fighting auto theft. Our local Peel Regional Police has one of the largest investigative teams in the country, and we are directing our federal agencies through this funding to increase collaboration on investigations. This includes exploring detection technology solutions and exploring the use of advanced analytical tools, such as artificial intelligence. We will continue our work to protect Canadian families.

Speaking of Canadian families, this budget reinforces an important national program that has already been delivering for thousands of Canadians, which is child care. Before I go any further, I want to recognize the work of our status of women committee on this file in our ongoing study on women's economic empowerment. I also want to take a moment to thank all members of the Standing Committee on the Status of Women for their hard work.

It is important to do everything we can to support our children. That is why the government launched a Canada-wide affordable child care system in 2021, with the final agreement announced in my riding of Brampton South. We know that more needs to be done to ensure that even more families are able to secure space for their children. This is why budget 2024 proposes to launch a child care expansion loan program. The program would offer low-cost loans and non-repayable contributions to public and not-for-profit child care providers to build more child care spaces and renovate child care centres. The new child care spaces created through the program would increase access to affordable child care in Brampton and across Canada, saving more families thousands of dollars per child every year.

We know that we need to do more to support our children, as nearly one in four do not get enough food. This has real impacts on their opportunities to grow and learn, which is why the federal government is taking decisive action to launch a new national school food program and work with provinces, territories and indigenous partners to expand access to school food programs. The national school food program is expected to provide meals for more than 400,000 kids each year. This program would ensure that our future generations have what they need to grow and help make Canada a better place for all.

As a mother, I know that it is important for us to support our children when they grow up and start their careers. Those of Canada's generation Z need the confidence of knowing they will find a good job that will help them get ahead. To help younger Canadians pursue and achieve their dreams, the government is investing to create more youth job opportunities and ensure that hard work pays off for the next generation. Budget 2024 is proposing that the Government of Canada creates 90,000 youth job placements across the country. That includes a significant expansion of the Canada summer jobs program and the youth employment and skills strategy program.

This would mean that moms and dads in Brampton could count on the availability of good jobs for their children who are starting their careers. These jobs will help students gain much needed work experience and support in areas facing labour shortages, such as health care or in senior homes. In my riding of Brampton South, I know Holland Christian Homes. There are many senior homes where students have worked before, and they will now have the opportunity to work again.

Speaking of our seniors, we know that, after a lifetime of working hard, Canadians deserve to know they have a secure and comfortable retirement. Their golden years are meant to be spent in retirement with their families. Canada's social safety net delivers the promise of a safe and secure retirement for everyone.

Seniors rely on these investments to keep a roof over their heads and food on their plates. The government's largest program, old age security, will deliver security to more than seven million seniors this year, and our government has increased the maximum GIS benefit for single seniors.

Nine provinces and territories have announced agreements with the federal government so far. We have also been working hard on the aging with dignity agreement, which would provide $5.4 billion to include access to home care. After a lifetime of their hard work and helping Canada through some of its toughest times, we have our seniors' backs.

As chair of the all-party diabetes caucus, I am proud of our government's commitments to the national diabetes framework and launching a national pharmacare program. This is something I have been advocating for since I passed my Bill C-237, an act to establish a national framework for diabetes. Our government is now investing in a national pharmacare strategy with a focus on diabetes medication and supplies.

Budget 2024 proposes to provide 1.5 billion dollars over five years, starting in 2024-25, to Health Canada to support the launch of the national pharmacare plan. This investment would save Canadians thousands of dollars per year on contraceptives, as well as diabetes medication and supplies. Improving access to diabetes medication will help improve the health of millions of Canadians. That will reduce the risk of serious life-threatening health complications.

Budget 2024 is delivering fairness for every generation. That is why I urge all members of Parliament to support the passage of the bill.

Diabetes

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. Speaker, November is Diabetes Awareness Month in Canada.

Earlier this week, I attended the Canadian screening of The Human Trial, a Hollywood documentary by a Canadian filmmaker, Lisa Hepner, on the incredible work of researchers to find the cure for diabetes.

Canada is not only the birthplace of insulin, but Canadian researchers also discovered stem cells, islet cells and developed the Edmonton protocol.

Canadians living with diabetes know that we are united in our support for them as we supported Bill C‑237, which established the national framework for diabetes.

Next week on November 14, I will be proud to host the third annual World Diabetes Day flag-raising ceremony in my city of Brampton. I invite all residents to join me.

Let us continue to combat diabetes together.

National Strategy for Eye Care Act

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I will be careful of that.

Unfortunately, the COVID-19 pandemic worsened the issue of vision loss in Canada, as eye surgeries were cancelled or delayed. Wait times to see vision care providers also increased over the course of the pandemic. That is why a national strategy for eye care is essential. It would provide a comprehensive road map, laying out a common direction and shared leadership. It would build collaboration among researchers, medical professionals and community organizations to develop innovative approaches to combat eye diseases and preserve sight.

In 2021, the CNIB opened a new centre in Brampton South, providing access to innovative technology and training for Bramptonians with sight loss. It is doing incredible work, and I am confident that Bill C-284 would bring us one step closer to empowering Canadians impacted by blindness with an integrated approach.

As members in this House know, Bill C-237, the National Framework for Diabetes Act, passed unanimously in 2021. I want to touch on how blindness can be a serious complication because of diabetes retinopathy, and I also want to recognize Diabetes Canada's work on this issue as well.

Earlier this year, I met an advocate named Ryan and his dog named Joe. Ryan lives with diabetic retinopathy. He told me about the challenges Canadians with vision impairments face using their insulin pumps. He and many other Canadians are experiencing these hardships, so we need to work together to remove those barriers.

Living with blindness, especially as a result of chronic disease, is an experience that is difficult for people without visual impairment to truly understand. This further underscores the need to have a coordinated strategy so that we can work together with provinces and territories, indigenous peoples and other partners to improve health outcomes. Through this approach, we can proactively identify and intervene in cases of diabetic retinopathy, mitigating the risk of vision loss.

We know that with early intervention and coordinated care, vision loss can be preserved. Of vision loss cases, 75% can be prevented if patients are diagnosed early and have access to treatment. We know that providing hope and better health outcomes for individuals affected by eye diseases is transformational. Already, the Government of Canada is leading and supporting a range of activities related to eye disease prevention and treatment.

I would like to talk about the investments announced in budget 2023 to strengthen our public health care system.

Budget 2023 commits $196 billion in funding to support our health work force; reduce backlogs; expand access to family health, mental health and substance use services; and modernize our health system. This is to ensure provinces and territories can provide the high quality and timely health care Canadians expect and deserve.

We see the surgical backlogs and the impacts on our systems, and we are addressing that need. Surgical backlogs, including vision-related surgeries, are a key part of this plan and are a health system priority of this government. Budget 2023 includes a $2-billion one-time top-up to provinces and territories to address urgent pressures in emergency rooms, operating rooms and pediatric hospitals. In addition, Indigenous Services Canada’s non-insured health benefits program also provides vision care to eligible first nations and Inuit beneficiaries where they are not otherwise covered by other plans or programs.

The government has also made significant investments in vision loss prevention and research. Over the last five years, the Canadian Institutes of Health Research has invested approximately $61 million in vision-related research. This research spans the spectrum of prevention, diagnosis, treatment and management of various vision-related conditions.

These investments contribute to the evidence base needed to improve health systems and health outcomes for Canadians experiencing vision loss.

Finally, I wish to highlight that medically necessary vision care services are covered by provincial and territorial health insurance plans. Any vision care service that must be performed in a hospital is covered and supported under Canada’s public health care system. The federal government is committed to continue working with provinces and territories on our shared health priorities, including those related to vision care.

In conclusion, Bill C-284 would allow the Minister of Health to develop a national strategy to support the prevention and treatment of eye disease. It would facilitate engagement with provinces, territories, key stakeholders and partners to ensure that we are all pursuing common objectives in the vision care space, along with sharing best practices. This bill would complement existing work and research efforts, supported by provincial and territorial governments, and the Canadian Institutes for Health Research.

Once again, I wish to thank the hon. member for Humber River—Black Creek for putting forward this important bill. I know that my residents in Brampton South and, indeed, all Canadians are counting on us to act quickly to prevent and treat eye diseases. I encourage members to vote in favour, as we continue to strengthen our efforts on vision care in Canada.

Child Health Protection Act

[Jean-Denis Garon, Bloc, Mirabel, QC]

Madam Speaker, I am very pleased to see you back here in the House. I sincerely hope you had a nice summer. It was probably much like mine, with a lot of time spent resolving problems with passport applications. Of course, we always enjoy helping our constituents.

We are considering a bill with noble goals and intentions. Bill C-252 deals with the prohibition of food and beverage marketing directed at little children. I am pleased to speak to the bill because I will probably be at the standing committee on health for the clause-by-clause study. There are a number of items that I will be very interested in looking at; I will come back to that later.

First, we must acknowledge that there is an obesity problem among adults and children. If we believe a report from the public health officer for Quebec dating from 2016, the trend is still clear. Fully 52% of the population is overweight. Approximately 18% of people are obese, and that is also true among children between the ages of two and 17. In children aged two to 17, the prevalence of obesity or excess weight has increased from 15% to 26% over time. The diagnosis is clear. We need to act. I think there is a role for public policy-makers and governments to play. That is essentially what this bill does, without claiming to fix everything.

We know the long-term consequences of childhood obesity. There is no clear cause-and-effect relationship, but we do know that there is an epidemiological link to cardiovascular disease, diabetes, musculoskeletal conditions and certain cancers. Preventing these diseases becomes even more important. Obviously, this is a prevention bill. However, the Liberal government, which includes the member who introduced this bill, refuses to give Quebec and the provinces the health transfers they are calling for in order to be able to provide people with the necessary care.

I would therefore encourage my colleague to pressure her caucus and her government. I know her well because her riding is not far from mine. I know her constituents are like mine. They think health transfers are important. I also know she has a member of the National Assembly in her riding, one of the MNAs who unanimously called for health transfers. It is important to listen, but it is also important to look ahead, and there are a lot of good things in this bill.

Some will see this as proof the government thinks it knows everything. They will see the bill as a socialist conspiracy. That is pretty much what my Conservative colleague was insinuating.

I can actually hear a small child in the House of Commons. That child may one day be protected by this piece of legislation.

Children cannot differentiate between information and persuasion. Their brains are not capable of it. The Standing Committee on Health heard from the president of the Association des pédiatres du Québec about child development. Children begin to distinguish persuasion from content around four or five years of age, but it is not until they reach seven or eight that they can really tell the difference between ads and content. They may not really understand until they are 11 or 12.

Most of the time, these ads are not meant to convince anyone, to provide information or to help consumers make informed decisions. It is persuasion aimed at children who are not in a position to make rational and informed decisions, which is why we need to support them.

I can assure the House that the Bloc Québécois will vote in favour of the bill and this principle. I think it is a good thing. This bill is also consistent with the Quebec government's 2019 action plan to reduce the consumption of sugary drinks and promote water. Water can be drunk, but oil cannot. The Quebec government states in its report that the consumption of sugary drinks and the marketing practices that promote their consumption must be de-normalized. There is, after all, a cause and effect relationship.

Of course, someone in Alberta could always make comparisons and think they are just as thin as a Quebecker, and wonder why Quebeckers have advertizing laws. Such statements do not work. These statistics and comparisons between different jurisdictions are pretty shaky. This is counterfactual thinking, and these arguments are pretty weak. At the very least, it is hard to imagine that this bill will make the situation any worse.

Quebec's policy was obviously designed to prompt a reduction in the consumption of sugary drinks. The Bloc Québécois is here in Parliament to express the consensus of the Quebec National Assembly, the vision of Quebeckers and the vision of the Government of Quebec. It would be consistent with our mission in the Bloc Québécois to support this bill, at least at second reading so that it can be sent to committee.

This bill also reflects the recommendations made by the WHO in 2010. The Government of Quebec was not alone in considering this issue. This WHO report applies to the whole world, not just Quebec. One of the recommendations made by the WHO in its 2010 report reads as follows: “Given that the effectiveness of marketing is a function of exposure and power, the overall policy objective should be to reduce both the exposure of children to, and power of, marketing of foods high in saturated fats, trans-fatty acids...”. In short, we need to take action.

Experts have recognized that there is a link between marketing and consumption. We are not saying that it is a definitive link. We are saying that there is a link and we must act. That is consistent with the Quebec government's position, the Quebec government's strategy, the WHO's position and how the Bloc Québécois has voted in the past. I am thinking in particular of Bill C‑237, which, I believe, was passed unanimously by the House of Commons at first or second reading. We are being consistent with our past voting and support. We will continue in that vein with the bill being studied. There is also Bill C‑228 on food and beverage marketing directed at children; it died on the Order Paper.

It is only fitting that we support this bill. I invite my colleagues, including the Conservatives, to vote in favour of this bill. Let us support it because as parliamentarians we know that second reading is not a final step. If there are concerns to be addressed, corrections to be made and discussions required, I can assure my colleague on the Standing Committee on Health that she will find a colleague ready to work constructively on this bill, which I find quite promising. I know that it is well intentioned. Let us refer it to committee.

We are looking for some assurances in committee. First of all, Quebec did not help develop the federal, provincial and territorial framework for action to promote healthy weights. Quebec does not endorse any pan-Canadian response that encroaches on its jurisdictions, so we will have to ensure that this holds true for this bill. Furthermore, Quebec alone is responsible for developing and implementing programs to promote a healthy lifestyle within its borders. I say that, but, at first glance, it does not appear that the bill currently under consideration encroaches on our jurisdiction.

Plus, a simple reminder that Quebec has full jurisdiction over health matters, which I feel needs to be pointed out every day, if not every hour. Furthermore, we must ensure that the bill will not interfere with Quebec's jurisdiction over civil law. Section 248 of Quebec's Consumer Protection Act already prohibits advertising directed at children.

The bill does not seem to go much further, except that the Quebec legislation does not currently regulate store windows, displays, containers, packaging, labels, and so on. Some procedures will therefore need to be reviewed. Perhaps we will find out why my Conservative colleagues do not like the Quebec legislation.

I have said it many times and I will say it agin. The intention is good. The public health objective is good. The reasoning behind the bill is quite rational and well thought out. Now, once again, as is often the case with issues related to health legislation, there is a fine line between Quebec's jurisdiction and the federal government's jurisdiction. However, it is obviously worth it, because the health of our children is of the utmost importance. It is worth passing this bill at second reading, sitting down and studying it diligently. I invite all my fellow parliamentarians to do just that.

[Andrew Jones, Executive Director, Government Affairs, Policy and Advocacy, Diabetes Canada]

Thank you, Mr. Chair.

I'm Andrew Jones, executive director of government affairs, policy and advocacy at Diabetes Canada. It's a pleasure to be here this morning to assist in your study of Bill C-19. I'm looking forward to discussing an important issue for people affected by diabetes that aligns with your current study, which is the disability tax credit.

Before I dive into the details surrounding the disability tax credit, let me tell you a little about the burden of diabetes and a number of federal government initiatives from 2021 that are intended to address this burden.

Many of you will know that Canada gave the world the gift of insulin more than 100 years ago. It's a discovery that ranks among the leading achievements of medical research. Because of insulin, millions of people around the world with diabetes live long lives. However, insulin is not a cure and we are not at the finish line. Recently, Diabetes Canada released new diabetes figures that show a steady, continued increase in diabetes in our country, with 11.7 million people in Canada living with diabetes or prediabetes. Just a decade ago, that number was 9.2 million. That's a shocking 27% increase.

Diabetes continues to affect more Canadians than ever before, despite concerted effort and numerous diabetes-related accomplishments in Canada and throughout the world. There is no denying that diabetes is an epidemic.

The good news is that in 2021, in honour of the 100th anniversary of the discovery of insulin in Canada and in recognition of the huge and growing burden of diabetes on Canadians, the federal government and all parliamentarians made significant and laudable commitments to improve prevention, management and research in diabetes. Canada proudly co-hosted a World Health Organization symposium on diabetes in April 2021, and jointly with them, launched the global diabetes compact.

The 2021 federal budget contained important commitments to funding research and developing a national diabetes framework. On June 29, 2021, royal assent was received for Bill C-237, An Act to establish a national framework for diabetes, which was unanimously supported by all parliamentarians. These commitments laid a critical foundation that we can build upon to meaningfully reduce the burden of diabetes in Canada by implementing the recommendations of Diabetes Canada's diabetes 360° nationwide strategy.

Diabetes Canada is eager to continue to collaborate with the federal government on this important and urgent work. Diabetes Canada continues to recommend that the federal government dedicate the necessary financial and human resources required to realize the 2021 budget and Bill C-237 commitments to implement a national diabetes framework, based on the diabetes 360° framework, as quickly and comprehensively as possible. Previous stakeholder consultations suggest an investment of $150 million in funding over seven years.

I'd like to also take a moment to discuss with you our concerns surrounding the disability tax credit.

I know our friends in the diabetes community, JDRF, appeared before you last week. You may be comforted to know that our position regarding the disability tax credit is well aligned with what you heard last week from JDRF.

We at Diabetes Canada ask that the federal government consider granting eligibility for the disability tax credit to all Canadians with diabetes who are on insulin therapy. We maintain that the current eligibility criteria that requires a life-sustaining therapy for an average of at least 14 hours per week is antiquated and unfair.

Furthermore, we support recommendation 14 of the Canada Revenue Agency's disability advisory committee. They recommend replacing the current eligibility requirements, including the 14-hour rule, with the following: “Individuals who require life-sustaining therapies...are eligible for the [disability tax credit] because of the time required to administer these therapies.... Without them, the individual could not survive or would face serious life-threatening challenges.”

Insulin therapy is on the recommended list of therapies. We believe that anyone who is on insulin therapy, regardless of whether they are living with type 1 or type 2 diabetes, would qualify for the disability tax credit following the advisory committee's recommendation because unfortunately without insulin, they would not survive or they would face serious, life-threatening challenges.

Everyone with type 1 diabetes and some people with type 2 need to use insulin as a treatment. To determine a dose of insulin multiple times a day, people with diabetes must problem solve, make numerous decisions and undertake many activities. These include consulting regularly with their diabetes specialist, checking blood sugar six or more times a day and maintaining a record of the blood sugar levels. With that, they must identify trends requiring alterations to treatment, make complex calculations accounting for such things as the time of day, the amount or type of food they are eating, the activity or exercise they plan to do in the coming hours, how much stress they are under and whether they are fighting a cold or flu.

All of these factors can affect blood sugar levels. Many of these activities are not easily quantified and/or permitted to be counted towards the antiquated 14 hours a week disability tax credit eligibility criteria.

The disability tax credit helps offset costs and enables eligible Canadians with diabetes to manage their condition. We trust that you will amend Bill C-19 to make it easier and fairer for people living with diabetes and relying on life-sustaining therapy to qualify for the credit.

Thank you for your attention. I look forward to answering any questions you might have.

[Julie Dzerowicz, Liberal, Davenport, ON]

Thank you so much, Mr. Chair.

I want to thank all the presenters for their excellent presentations and for being here today.

My first question is for JDRF Canada.

In the last Parliament, my colleague Sonia Sidhu sponsored Bill C-237, which was adopted with support from all parties. Bill C-237 set a requirement for the government to present a national framework for diabetes. This framework, I understand, is due by the end of June.

Have you been consulted by the government on this framework, and what do you hope to see from it?

Health

[Jean-Yves Duclos, Liberal, Minister of Health]

Mr. Speaker, I would like first to thank the member for Brampton South for her strong advocacy on behalf of the diabetes community in Canada. We want to recognize the severe impact that diabetes has on three million Canadians who live with the disease and their families.

Thanks in large part to the hard work of the member of Parliament for Brampton South and her bill, Bill C-237, we are now developing a national framework for diabetes, strengthened by a $25-million investment from budget 2021. There is much more work to do, but thanks to the member and what we are going to do to prevent diabetes and care for people, we are going to get there.

[Sonia Sidhu, Liberal, Brampton South, ON]

Mr. Speaker, to commemorate the 100th anniversary of the discovery of insulin in Canada, we raised the World Diabetes Day flag in Brampton to raise awareness. In June, the House passed Bill C-237, which will lead to a national diabetes strategy.

Can the Minister of Health tell us what steps the government is taking to ensure that Canada is leading in the fight against diabetes?

[Justin Trudeau, Liberal, Prime Minister]

Mr. Speaker, I want to thank the member for Brampton South for her unwavering advocacy on behalf of Canadians living with diabetes.

We recognize the impact that diabetes has had on the health of Canadians and their families. That is why, in budget 2021, we are investing $35 million to develop a national framework for diabetes to help Canadians get access to prevention and care. This will build on the important legislation put forward by the member in Bill C-237.

We will keep working to support diabetes prevention and care for all Canadians.

[The Chair, Liberal, Ron McKinnon]

Welcome, everyone, to meeting number 40 of the House of Commons Standing Committee on Health.

The committee is meeting today pursuant to Standing Order 106(4), as requested by four members of the committee, to discuss a work plan until the summer recess.

Before I recognize Ms. Rempel Garner to move her motion, I would like to acknowledge and recognize that Ms. Sidhu's private member's bill, C-237, an act to establish a national framework for diabetes, just passed third reading in the House. On my own behalf, and since it passed unanimously, I dare say on behalf of the committee as well, congratulations indeed.

Ms. Rempel Garner, if you please, go ahead.

National Framework for Diabetes Act

[The Speaker, Liberal, Anthony Rota]

It being 3.18 p.m., pursuant to order made on January 25, the House will now proceed to the taking of the deferred recorded division on the motion at third reading stage of Bill C-237, under Private Members' Business.

Call in the members.

The House resumed from May 26 consideration of the motion that Bill C-237, An Act to establish a national framework for diabetes, be read the third time and passed.

[Sonia Sidhu, Liberal, Brampton South, ON]

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

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

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

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

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

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

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

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

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

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

[Christine Normandin, Bloc, Saint-Jean, QC]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[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 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.

[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—

[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.

[Kevin Lamoureux, Liberal, Parliamentary 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.

[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.

[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.

[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.

[Sonia Sidhu, Liberal, Brampton South, ON]

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

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

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

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

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

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

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

The director general of the WHO said:

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

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

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

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

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

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

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

Back in the spring of 2019, I was proud to bring forward the unanimously supported motion to declare November as Diabetes Awareness Month in Canada, but now it is time for more than awareness. It is time for action. Canada, 100 years ago, made the biggest leap in the treatment of diabetes.

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

The House proceeded to the consideration of Bill C-237, An Act to establish a national framework for diabetes, as reported (with amendment) from the committee.

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

Mr. Chair, I move that Bill C-237, in clause 2, be amended by adding after line 21, on page 2, the following:

(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.

Simply put, there has been an ongoing challenge for people with diabetes to qualify for the disability tax credit. A number of organizations have expressed the difficulty of that. I can attest as a parent that it was probably the third try before we were able to get it for André. I can imagine for individuals who are not as lucky as we are to be able to work for themselves and get these kinds of things done....

It's simply to try to facilitate the work and to acknowledge that there is a disability tax credit there. I think it's a very easy and calming kind of resolution, without changing the intention of the bill.

[Sonia Sidhu, Liberal, Brampton South, ON]

That is why Bill C-237 is a pathway towards a strategy. Diabetes 360° is an example of such a strategy.

It isn't appropriate to tell Health Canada what should be implemented at this point, but I [Technical difficulty—Editor] and research plan, and we must let Health Canada look at it for implementation. That is why it's a pathway. I know Diabetes Canada is working well together with us. That is why I brought forward Bill C-237.

We need that strategy. I personally support diabetes 360° and the next level. That is why I brought forward Bill C-237. We need a strategy.

[Kimberley Hanson]

Yes, thank you, Monsieur Thériault.

I think there's no difference between a national framework and a national strategy. When we were drafting diabetes 360°, we debated strongly which words to use to describe what we were trying to accomplish. It is Diabetes Canada's fervent hope that when Bill C-237 passes into law, the framework that it requires to be tabled before Parliament will be heavily inspired by or informed by the diabetes 360° strategic framework.

I can't speak to why we find ourselves in the position that we do in 2021, but I can say that we've seen in the case of other illnesses or disease groups—such as cancer—that when we take a coordinated approach, when we help facilitate information sharing and the sharing of best practices across jurisdictions, we can materially improve the health care of Canadians and really make a difference in reducing the impact of these diseases. I would definitely agree that it's past time that we acted, but the only time we have is now, so let's act now to embrace this bill and move forward.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Van Bynen. It's a great question. Thank you for your support all the way.

You're right. We need to consult with the indigenous stakeholders as well because, as you know, on reserve and in indigenous populations there are higher rates than with any others. We need to consult with indigenous stakeholders, provinces and territories. The government needs to consult with the stakeholders such as Diabetes Canada and JDRF and listen to the proposals.

Ms. Hanson mentioned diabetes 360°, which we all supported in the HESA committee. It has very good aspects and I hope it can address many indigenous concerns as well.

There have been consultations on subjects that help those with diabetes. For other aspects, like Canada's food guide, there has not been a national holistic consultation called for, and that is why my bill calls for that. It would bring together both levels of government, indigenous partners and other stakeholders with the common goal of creating a national diabetes strategy, which I'm asking for in my bill, Bill C-237.

It's also to address Canadians of all different ages and demographics, and will be sensitive to cultures and socio-economic backgrounds, too.

[Juliette Benoît, Volunteer, JDRF Canada]

Thank you, Mr. Prowten.

Good afternoon, everyone.

My name is Juliette Benoît. I'm 17 years old, and I'm from L'Assomption, Quebec. I've lived with type 1 diabetes for almost five and a half years.

My life changed when I was 11 years old. I was diagnosed shortly after Hallowe'en. It is quite unusual for a child to ask to stop trick-or-treating to go to the bathroom.

I was thirsty and hungry, but the more I ate, the more weight I lost. I had also lost my energy and zest for life. As my family really started to worry, my parents took me to the hospital. I remember the cold walls and the staff trying to reassure me, but I was rather annoyed by all the questions I was being asked. Finally, they put three words and a number to my symptoms: “type 1 diabetes”.

After that, I took all kinds of training to tame the monster that was inside me. I thought it was rather strange to see my mother, father, step-mother and step-father sitting around the same table trying to make jokes to lighten the situation.

Before I knew it, I was at home, 11 years old, giving myself injections and trying to survive it all. The child I was was being asked to be an adult, to be strong and to hold it together. The diabetes diagnosis was really what I thought was the worst for a child. I was told I had to give myself shots several times a day and stop eating candy. That's really how I saw my disease.

Fortunately, thanks to research, I now have an insulin pump that allows me to administer insulin without injection and a continuous blood glucose reader that allows me to know my sugar levels faster and without injections, in addition to allowing me to adjust my insulin doses more easily.

That said, it's not a cure. These devices make my daily life easier, but I still spend many hours a day caring for my diabetes. Imagine, before and after eating anything, before, during and after physical activity, when I'm not feeling well and at many other times, I have to check my sugar level, calculate the carbohydrates of what I eat and adjust accordingly.

That's why Bill C-237 is so important to me. The research needs to continue in order to find ways to achieve a genuine cure. Canadians with diabetes need support from the federal and provincial governments to make insulin pumps and continuous blood glucose monitoring systems affordable. Diabetes is a very expensive and difficult disease to live with.

We need help managing the stress and mental burden of the illness, and we also need it to reduce the stigma. It's very important that people stop asking me if I have diabetes because I ate too much sugar, for example. This is an annoying remark that all type 1 diabetics hear on a daily basis.

At 11 years of age, I became a mini-adult, but more importantly, a warrior. I have become a symbol of strength for all type 1 diabetics. Now we just have to hope that the bill to create a national diabetes framework will pass so that real action can be taken.

Thank you for your attention.

[Dave Prowten, President and Chief Executive Officer, JDRF Canada]

Thank you, Mr. Chair, and members of the committee.

I'm joined today by Juliette Benoît, a JDRF youth advocate who joins us from L'Assomption, Quebec, and will speak to the lived experience of type 1 diabetes. Just as background, Juliette was one of our two youth co-chairs during our Kids for a Cure this past November and would have met some of you during those sessions.

We're pleased to speak today in support of Bill C-237, the national framework for diabetes act. JDRF is grateful to Ms. Sidhu for her leadership in introducing this bill, as we are to those MPs and other diabetes organizations like Diabetes Canada that worked hard to develop a diabetes strategy for Canada.

Our mission is to accelerate life-changing breakthroughs to cure, prevent and treat type 1 diabetes and its complications. Type 1 diabetes causes the body's immune system to attack and destroy insulin-producing cells in the pancreas, making children and adults dependent on daily injections or infusions of insulin for life. As other have noted, 2021 marks the 100th anniversary of the life-changing discovery of insulin, rightly celebrated as Canada's gift to the world. As Banting himself said, “insulin is not a cure”.

The incidence rate for type 1 diabetes is growing at over 5% a year in Canada, which is higher than the global average. The incidence rate for type 2 diabetes is growing even faster, as is the proportion of annual health budgets taken up by diabetes.

Therefore, JDRF would like to encourage passage of this bill. It will be critical that all levels of government work together to make this diabetes strategy impactful by fostering conditions that prevent diabetes and take actions to keep diabetics healthy, such as finding ways to make diabetes technologies more affordable and accessible as their price is out of reach for many working families.

For type 2 diabetes, prevention means lifestyle interventions. For type 1, prevention means investment in new research into the autoimmune response that causes it.

I'd like to take a moment here to acknowledge the JDRF-CIHR partnership to defeat diabetes. It's a remarkable collaboration between JDRF and the Government of Canada, which is up for renewal this year. Launched in 2017 with $15 million of funding through the CIHR and matched with $15 million from JDRF, this partnership is funding critical research to prevent diabetes complications and investigate groundbreaking immune therapies and stem cell-based cures.

It's important, too, that we focus our resources on psychosocial supports, as Kim Hanson just mentioned. Because we can't change what we don't measure, a robust strategy needs to track outcomes for both types of diabetes through a registry, repository or both.

I'd like to turn it over to Juliette to talk about the urgency for a national diabetes strategy.

[Kimberley Hanson, Executive Director, Federal Affairs, Diabetes Canada]

Good afternoon, committee members. I'm grateful to be living and working on the traditional lands of the Haudenosaunee, Anishinabe and Algonquin peoples.

I would like to begin by thanking you for the opportunity to appear before you today on this important bill, but more importantly for your ongoing work to improve and protect the health of all Canadians.

Never have I been prouder to be a Canadian than during the last year. Witnessing our elected officials work together in challenging and ever-changing circumstances to help Canadians weather the COVID-19 pandemic has been inspiring.

My proudest Canadian moment, though, might be when, earlier this month, members of Parliament from all parties unanimously voted in support of MP Sidhu's Bill C-237. As someone who has lived with diabetes and several of its complications for 25 years now, and who has lost many loved ones to its consequences, it was powerful to see every MP acknowledge that diabetes is a serious problem in Canada, and one we must take bold and urgent action to address.

In 2019 this committee studied diabetes strategies in Canada, as MP Sidhu mentioned, and recommended the following:

That the Government of Canada, in partnership with the 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, as outlined in Diabetes Canada’s Diabetes 360°: A Framework for a Diabetes Strategy for Canada. The partnership should facilitate the creation of Indigenous-specific strategic approaches led and owned by any Indigenous groups wishing to embrace this framework.

Those were your words, committee. You recommended this because you recognized that countries with a national framework or strategy to address diabetes do better.

Diabetes is less prevalent and people living with it experience fewer complications, which is why the World Health Organization recommends that each country develop a national diabetes strategy.

Still, Canada does not currently have such a strategy, and in the eight years since Canada last had a national diabetes strategy in place, nearly two million Canadians have received a diagnosis of diabetes. That is why Diabetes Canada, our colleagues at JDRF who are here today, and the community we represent feel such a strong sense of urgency that Canada act to reduce the burden of this disease on Canadians. With someone new diagnosed every three minutes in Canada, at least 12 preventable lower-limb amputations occurring every day, as well as 20 more deaths, we don't have a moment to waste in embracing Bill C-237 and implementing a nationwide approach to preventing type 2 diabetes and all diabetes complications.

The COVID-19 pandemic only heightens that sense of urgency. People who have diabetes have been shown to be at least three times more likely to die of COVID-19 than someone who does not have diabetes. Emerging research suggests that COVID-19 infection may be triggering new cases of diabetes, and the economic insecurity and physical inactivity triggered by the pandemic has put many of us at greater risk for type 2 diabetes and its complications.

People living with diabetes are significantly more likely to struggle with mental health challenges, including depression and anxiety. COVID-19 has also exacerbated that risk. I have barely left our home in more than a year now because of the risk if I catch COVID-19, and I know that many of my friends and colleagues living with diabetes are in the same situation. The sense of isolation and worry that all Canadians are experiencing during these times is powerful, and it adds to the mental and emotional burden of living with diabetes.

During COVID-19, many people are delaying accessing health care, and that appears to be increasing the risk of diabetes complications such as blindness and lower-limb amputation. As Dr. Karen Cross said at the most recent meeting of the all-party diabetes caucus, if diabetes before COVID-19 was the earthquake, COVID-19 is the ensuing tsunami. We must act now to minimize the impact of the tsunami of diabetes and diabetes complications that we are facing.

Bill C-237 will improve diabetes prevention and treatment, promote essential diabetes research, improve data collection and address health inequalities. It requires the Minister of Health to table a national diabetes framework in the House of Commons within one year.

Bill C-237 is strongly aligned with Diabetes Canada's diabetes 360° strategic framework, which was developed in collaboration with more than 120 stakeholders and has strong support not only from the entire diabetes community but also from other key health stakeholders, including the Canadian Cancer Society and the Heart and Stroke Foundation. Diabetes Canada encourages that, when Bill C-237 becomes law, the minister refer closely to the diabetes 360° strategy in preparing Canada's new national diabetes framework.

When Bill C-237 becomes law, Diabetes Canada will be pleased to collaborate with the government to define the national diabetes framework and to implement governance and evaluation mechanisms and supports for intergovernmental collaboration, to ensure that it quickly benefits the maximum number of Canadians possible. That is why Diabetes Canada strongly supports Bill C-237 and congratulates MP Sonia Sidhu for her leadership in tabling it and for her commitment to our cause.

We urge Parliament to pass this legislation quickly so that we can begin implementation as soon as possible, which is what Canadians want. In an Ipsos poll conducted in November 2020, 86% of total respondents and 91% of BIPOC respondents urged the federal government to embrace a national diabetes strategy urgently.

This year, Canada and the world are celebrating the 100th anniversary of the discovery of insulin by scientists at the University of Toronto. This momentous discovery saved the lives of millions of people around the world and is rightly recognized by most Canadians as one of our proudest achievements. By passing Bill C-237 now, the federal government can make a fitting recognition of the significance of this anniversary and begin to reap the human and financial rewards of a nationwide approach right away.

Thank you for your attention.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair, and colleagues.

It's my pleasure to speak today on my private member's bill, Bill C-237, an act to establish a national framework for diabetes.

Before I begin, I want to thank all members immensely for your support of this initiative at second reading. I'm glad to know we share the goal of fighting diabetes.

This year we commemorate the 100th anniversary of the discovery of insulin by Sir Frederick Banting and his partners at the University of Toronto. It was also at U of T that stem cells were discovered in the 1960s. These have led to promising research that may lead to a cure.

Since Canada has been home to these great inventions in the fight against diabetes, we should also have a comprehensive strategy to help those living with this disease.

We have 11 million Canadians living with diabetes or prediabetes. The number of diagnoses doubled in the last 20 years, and every three minutes, another Canadian is added to this list. In my own community of Brampton, almost every sixth resident lives with diabetes or prediabetes.

In my 18-year career as a health care professional, I saw patients with cardiovascular disease, kidney disease, amputations or high blood pressure and diabetes was frequently an underlying and complicating condition. That is why a strategy is so important. By effectively fighting or preventing one disease, we will make an impact on many others.

When you consider the expense to the public health care system and to individuals living with diabetes, it represents a massive financial burden. Every dollar spent fighting and preventing diabetes means greater savings down the line.

It is one of the most common chronic illnesses in Canada and the rate is only growing. Some Canadians are at increased risk of diabetes, such as South Asians, Black and indigenous Canadians. We also know that diabetes disproportionately affects Canadians with low income and education. Diabetes rates are three to four times higher among first nations than among the general Canadian population. Furthermore, indigenous individuals are diagnosed with type 2 diabetes at a younger age than other individuals.

The COVID-19 pandemic has disproportionately affected Canadians with chronic diseases, including diabetes.

For all these reasons, we need a cohesive national plan to respond to diabetes, one that coordinates funding for awareness, prevention, research and treatment, and that ensures equal access to treatment across Canada.

Mr. Chair, we can learn from Canada's past diabetes plans and programs, and we can make sure that the framework called for in Bill C-237 is data-driven, accountable and engaged with stakeholders such as Diabetes Canada, JDRF and others.

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

The framework would allow for the identification of gaps in present approaches, strengthen action to address health inequities in diabetes and decrease the duplication of efforts by coordinating across jurisdictions.

The bill calls for promoting research, data collection and treatment. It would offer an opportunity for indigenous people and organizations to engage in federal, provincial and territorial strategies using a distinctions-based approach.

It would make a difference in the lives of millions of Canadians. Back in April 2019, this committee conducted a study and released a report on this very issue.

Mr. Chair and Mr. Davies, you were both part of the committee at that time. The comprehensive report already outlines the steps the government should take in the fight against diabetes.

The number one recommendation in this report was that the Government of Canada, in partnership with the provinces and territories and in collaboration with stakeholders, plan and implement an approach for the prevention and management of diabetes in Canada through a national diabetes strategy. Bill C-237 mandates the minister to do just this.

The HESA report made 10 other recommendations. Among them were that the government explore options to reduce diabetes-related stigma and improve public awareness and education on diabetes; provide funding through the Canadian Institutes of Health Research for research into preventing and treating diabetes; hold discussions with the provinces and territories to explore possible approaches to providing uniform coverage for diabetes-related medication, supplies and equipment across Canada; work with the provinces and territories to explore possible approaches to improving access to health care for individuals living with diabetes in rural, remote and northern communities and address the difficulties faced by many Canadians in accessing a family physician; and work with the provincial regulatory bodies to ensure that health care professionals receive comprehensive education and training to properly identify and manage diabetes and diabetes-related complications in their patients.

I believe that with more coordination among all levels of government and stakeholders, we will be a better position to win the fight against diabetes. I know that the government will give full consideration to the HESA report and the dozens of witnesses who shared their expertise and experiences to help shape the recommendations. For example, I personally think the Diabetes Canada 360° proposal is an excellent one.

This past November I went to Banting House in London, Ontario, where the Flame of Hope, a perpetually burning torch that serves to honour all who have been affected by diabetes, is located. It is a reminder that we must still work for a real cure. It will only be extinguished when one is discovered.

The discovery of insulin is remembered as one of the greatest medical achievements of the 20th century. It was the first time the Nobel Prize for medicine went to someone outside Europe. It went to Canada. The best thing we can do as a country to honour this discovery is to recommit to helping everyone battling this chronic disease, whether they are patients, doctors, researchers or loved ones.

Mr. Chair and fellow committee members, Canadians have always been leaders in the fight against diabetes. I want to thank you all again for the support you have shown for this bill, which I hope will eventually lead to the day when we can extinguish that torch at Banting House. Canada gave insulin to the world. Why can we not lead the way?

Thank you, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

I call this meeting to order. Welcome, everybody, to meeting number 26 of the House of Commons Standing Committee on Health.

The committee is meeting today to study Bill C-237, an act to establish a national framework for diabetes and then proceed to the clause-by-clause consideration. After that, we will discuss the first report of the subcommittee on agenda and procedure.

I want to thank the witnesses for appearing today.

First up, we have Ms. Sonia Sidhu, MP for Brampton South, whose private member's bill this is. From Diabetes Canada, we have Ms. Kimberley Hanson, executive director, federal affairs. From JDRF Canada, we have Dave Prowten, president and chief executive officer, and Ms. Juliette Benoît, volunteer.

Ms. Sidhu, please go ahead with your statement.

[The Speaker, Liberal, Anthony Rota]

Pursuant to order made on Monday, January 25, the House will now proceed to the taking of the deferred recorded division on the motion at second reading stage of Bill C-237, under Private Members' Business.

The House resumed from March 8 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.

[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.

[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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[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.

[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.

[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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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.

[Ruby Sahota, Liberal, Brampton North, ON]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

We also need more reliable information about the availability of—

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Andréanne Larouche, Bloc, Shefford, QC]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[Sonia Sidhu, Liberal, Brampton South, ON]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[The Chair, Liberal, Ginette Petitpas Taylor]

No. Thank you so much for that. That's great.

Perhaps now we can proceed through each item. To be efficient with our time, we could maybe just go through them item by item, and if there are no questions or comments, we can dispose of them fairly quickly. We'll be able to address the ones for which there is debate.

Does that sound appropriate to everyone?

We'll start off, then, with Bill C-210. Does anyone have any issues or comments about that one? No.

Next is Bill C-238.

I see there are no comments, so we'll move right along to Bill C-224. Good.

Next is Bill C-215. No comments.

Next is Bill C-204, and now Bill C-229.

I'm not going to jinx it, but we're on a roll.

Now we have Bill C-218 and a motion, M-34.

Next we have Bill C-214, Bill C-220, Bill C-221, Bill C-222 and Bill C-213.

I love working with women.

Next is Bill C-223, followed by M-35.

Now we have Bill C-206, Bill C-216, Bill C-208, Bill C-205, Bill C-237, Bill C-225, Bill C-228, Bill C-236, Bill C-230 and Bill C-232.

[Sonia Sidhu, Liberal, Brampton South, ON]

moved for leave to introduce Bill C-237, an act to establish a national framework for diabetes.

Mr. Speaker, I am honoured to rise in the House today to introduce my bill, an act to establish a national framework for diabetes. Today, 11 million Canadians have diabetes or pre-diabetes. Brampton has the highest rate of diabetes. In the birthplace of insulin, how can we not take stronger action toward improving the lives of nearly one-third of Canadians?

Presently, 20 Canadians are diagnosed with diabetes every hour of every day. The national framework seeks to improve access to treatment and prevention of diabetes through education, consultation with the federal and provincial governments and indigenous groups, clinical practice guidelines and, most importantly, a united approach to ensure better health outcomes for Canadians.

Through my bill, I am confident that one day soon we will extinguish the torch outside Banting House. Together, we will find a way to defeat diabetes.

I want to thank the member for Coquitlam—Port Coquitlam for seconding the motion to introduce my bill.

I encourage all members in the House to join in support of improving the lives of millions of Canadians across Canada.

(Motions deemed adopted, bill read the first time and printed)