Bill C-64

Pharmacare Act

An Act respecting pharmacare

This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and obliges the Minister to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.

[Mike Bleskie, Advocate, Type 1 Diabetes, Canadian Health Coalition]

Through you, Mr. Chair, I thank you for the opportunity to be here.

My name is Mike Bleskie, and I have been a type 1 diabetic for 19 years. I'm also a gig worker in my 30s. As such, like many, I don't have private health insurance, and I either cannot qualify or cannot afford to pay for a plan myself.

Although Ontario's benefits cover a portion of my personal expenses, my out-of-pocket costs stand at about $450 a month, mostly from my continuous glucose monitor, which is not covered in Ontario, and my pump supplies. That leaves me with hard decisions about the cost of food and rent at the beginning of every single month. It also leads to situations in which I'm forced to consider rationing my supplies, which can lead to health complications.

My experience talking to nurses, doctors and other diabetics across Canada tells me that I am far from alone. Insulin is not a luxury for us; it is a basic necessity for every single type 1 diabetic. Without the proper treatment, we are exposed to complications like debilitating nerve pain, amputation and permanent blindness. A universal single-payer pharmacare system is the only policy that guarantees that every type 1 diabetic in Canada, regardless of their economic circumstance, can access live-sustaining therapy when they need it. Policies that attempt to fill gaps only leave more gaps that need to be filled later, such as what we have seen in Ontario with OHIP+ .

I urge this committee to support this bill promptly so that we can get insulin into the hands of diabetics as soon as possible. I'm also asking this committee to ensure that syringes, pen needles, pump cannulas and continuous glucose monitors are fully covered as part of the diabetic supply fund contained in Bill C-64, as these items represent the biggest expenses to most diabetics and, in many cases, are not part of public coverage in most provinces.

I appreciate your time, and we welcome your questions.

[Steven Staples, National Director, Policy and Advocacy, Canadian Health Coalition]

Thank you, Mr. Casey. It's a pleasure to be back here.

Dear members of the committee, my name is Steve Staples. I'm the director of policy and advocacy for the Canadian Health Coalition.

Our organization was founded in 1979. Our members work to defend and improve our public health care system. We comprise citizens, frontline health care workers' unions, community groups, students and public health care experts.

Members of the Canadian Health Coalition welcome the introduction of the pharmacare act, Bill C-64. This landmark legislation is an important first step in continuing progress toward a universal national pharmacare program.

Canada is the only country in the developed world that has a universal health care system that does not include universal coverage for prescription drugs outside of hospitals. Pharmacare is needed urgently to improve the lives of those living in Canada. As we have heard, one in five people reported to Statistics Canada that they do not have access to prescription drug coverage. Importantly, low-wage workers, immigrants and racialized people are hit the hardest.

In addition, the overall cost of drugs to the health system must be reduced. According to the PBO, prices for prescription drugs in Canada are roughly 25% higher than the median for OECD countries, and a single-payer pharmacare system with the power of bulk purchasing is the best route to negotiate lower prices from pharmaceutical manufacturers.

Canadian Health Coalition members heartily endorse the recommendations of the 2019 national advisory council on the implementation of national pharmacare led by Dr. Eric Hoskins, which was referenced earlier.

A nationwide program to achieve public coverage for contraception and diabetes medicine and related equipment, delivered by a single-payer approach through provincial health systems, is a historic step in the direction recommended by Hoskins in his report on pharmacare, but there are many more steps to achieve universal coverage of a national formulary of medicines.

We urge the government to ensure that the legislation adheres to a single-payer, national universal public delivery in partnership with provinces and territories, along with adequate funding and accountability measures, in accordance with the principles of the Canada Health Act.

I would like to share the remainder of my time with my colleague, Mike Bleskie.

[Jim Keon, President, Canadian Generic Pharmaceutical Association]

Thank you, Mr. Chair.

The Canadian Generic Pharmaceutical Association and its Biosimilars Canada division would like to thank the committee members for this opportunity to contribute to the study of Bill C‑64, An Act respecting pharmacare.

Making medicines more affordable and accessible is the key value proposition of generic and biosimilar medicines, which today are used to fill more than three-quarters of all prescriptions in Canada. Expanding the use of generics and biosimilars helps drug plans to fund innovative treatments for patients and contributes to the overall sustainability of drug plans.

Not surprisingly, maximizing the use of these cost-efficient treatments to help fund pharmacare was a key recommendation of the pharmacare advisory council report in 2019.

We have provided a brief to members and will focus our remarks today on three main areas: the medications to be covered for patients under the proposed pharmacare regime, guiding principles for bilateral agreements, and bulk purchasing, which has not been defined.

On the list of drugs, expanding access to ensure all Canadians can benefit from the life-saving and life-altering medicines they need is an important objective. However, the list of diabetes and contraceptive medications in the February 29 pharmacare announcement is not comprehensive. There are important gaps that need to be addressed. We have highlighted these in our brief.

The current non-comprehensive approach also raises patient equity concerns, as it could lead to suboptimal prescribing of the medicines that are made available to the public for free and lead to suboptimal health outcomes for patients.

We are also concerned that the non-comprehensive approach may provide a disincentive for public drug plan formularies to continue their coverage of a broad range of prescription medicines and provide a disincentive to expand coverage to include new drugs in the future. These same concerns apply to drug plans provided by Canadian employers.

We recommend that all diabetes drugs and contraceptives that are currently reimbursed by public drug programs in Canada be covered if pharmacare is implemented. This principle should also apply to medicines added in the future.

On guiding principles, under Bill C-64 the federal government must negotiate and enter into bilateral agreements with individual provinces and territories. An important guiding principle for drug formulary management that is already employed by public drug programs in Canada is to reimburse for only the low-cost alternative product of a pharmaceutical active substance.

In order to help ensure the sustainability of the plan, Bill C-64 should be amended to clarify that only generic and biosimilar medicines will be reimbursed once they are authorized for sale by Health Canada and enter the Canadian market. This principle should be included in all bilateral pharmacare agreements.

On bulk purchasing, “bulk purchasing” is not defined in Bill C-64. It is not clear what this means. It is important to recognize that Canadian governments already combine their purchasing power to negotiate internationally competitive drug prices for Canadians. They do this through the pan-Canadian Pharmaceutical Alliance, or pCPA.

It is critical that the pharmacare regime respect the existing pharmaceutical pricing infrastructure to ensure stability of the Canadian drug supply. This will ensure that Canadians continue to benefit from access to both cost-saving generic and biosimilar medicines and the innovative new medicines Canadians need.

Prices for generic medicines are controlled through the pCPA tiered pricing framework. This provides a stable and predictable environment for generic manufacturers to continue to provide existing medicines for Canadians and make the investments to launch new cost-saving drugs.

According to pCPA, joint efforts between pCPA and CGPA have resulted in savings of more than $4 billion to participating drug plans over the past 10 years. These savings will continue to grow through a new three-year agreement between CGPA and pCPA that came into force on October 1 of last year.

The pCPA also negotiates prices for biosimilar medicines that are set to be significantly lower than the list price for the original biologic drugs. The expanded use of biosimilars has saved public drug plans hundreds of millions of dollars that have been reinvested into coverage for innovative new therapies and the overall sustainability of drug programs.

We recommend that governments continue to exercise their power to collectively negotiate drug prices in Canada through the pCPA.

In closing, thank you again for inviting the CGPA and its Biosimilars Canada division to appear as witnesses on Bill C-64. Jody and I would be pleased to answer any questions you may have.

Thank you.

[Majid Jowhari, Liberal, Richmond Hill, ON]

You talked about portability. Can you explain what that is? It's not included in pharmacare under Bill C-64.

[Majid Jowhari, Liberal, Richmond Hill, ON]

Okay. There is a list, and the list is available. Thank you.

I want to go back to clause 4 of the bill, which states that the minister must, when working with the pharmacare partners to implement national universal pharmacare, consider principles relating to the accessibility, affordability, appropriate use and universal coverage of pharmaceutical products across Canada. The minister must also consider the Canada Health Act.

Can you explain the similarity that exists between the principles outlined in clause 4 of Bill C-64 and the criteria set out in the Canada Health Act?

[Majid Jowhari, Liberal, Richmond Hill, ON]

Thank you, Mr. Chair.

Thank you to the officials for the hard work you've done on this and for coming here today.

Unfortunately, I'm going to follow on the same theme as my colleague Dr. Powlowski, who has led us down this path.

In clause 2 of Bill C-64, pharmacare is defined to mean “a program that provides coverage of prescription drugs and related products.‍” I understand “prescription drugs”. “Related products”, however, are not defined. I think that may leave a lot of room for interpretation.

What does “related products” mean in the context of Bill C-64?

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Thank you.

I'd just like to make sure that you received the statement issued a few hours ago by nine Quebec labour and community groups calling for the adoption of Bill C‑64. Did you receive it? If not, I can provide it to you. The Union des consommateurs, the Centrale des syndicats démocratiques and the Confédération des syndicats nationaux, to name a few, were very clear. There's a consensus in Quebec in favour of the bill.

I come back to the issue of the approval process of Health Canada. I think my Conservative colleague cut you off, but it's important for members of the committee to understand. Is it a 300-day period for approval, through Health Canada, from the application date to availability for consumers? I just want to understand what you were saying.

[Peter Julian, NDP, New Westminster—Burnaby, BC]

I'm pleased to have the opportunity to speak now, Mr. Chair, because I have an announcement to make. My Bloc Québécois colleague seems to be suggesting the opposite of what nine major organizations in Quebec stated just a few hours ago. These organizations include the Union des consommateurs, the Centrale des syndicats démocratiques, the Coalition solidarité santé, the Confédération des syndicats nationaux, the Fédération interprofessionnelle de la santé du Québec, the Fédération des travailleurs et travailleuses du Québec, the Table des regroupements provinciaux d'organismes communautaires et bénévoles, to name just a few.

These organizations, which represent over two million Quebeckers, are saying that they applaud Bill C‑64 introduced by the federal government: “Never have we been so close to establishing truly public and universal pharmacare. Quebec's hybrid public‑private program is creating an unsustainable two‑tiered system that must be corrected.”

In the brief they submitted today, these organizations point out that the current Quebec pharmacare program is far from guaranteeing everyone reasonable and equitable access to medication, as set out under Quebec's Act respecting prescription drug insurance. These organizations are saying that Bill C‑64 puts in place a framework leading to the creation of universal and public pharmacare. They stated the following: “We're calling on the federal government not to give in to the provinces and territories that are demanding the right to opt out unconditionally and with full financial compensation.”

Minister, given that this large coalition representing a significant proportion of the population of Quebec is saying that it supports Bill C‑64, should Quebec members of Parliament listen to it?

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Chair.

Thank you, Minister and your team, for being here with us.

The discussion is very important. It's historic legislation that aims to increase equitable access to contraceptives and diabetes medication.

Minister, as you know, important progress has been made in our country with the national framework to fight diabetes. As we discuss Bill C-64, can you update this committee on the progress in implementing the national framework for diabetes as well?

[The Chair, Liberal, Sean Casey]

I call this meeting to order.

Welcome to meeting number 116 of the House of Commons Standing Committee on Health.

Before we begin, I'd like to ask all members to consult the cards on the table for guidelines on preventing audio feedback incidents.

Please take note of the following preventive measures that are in place to protect the health and safety of all participants, including the interpreters: Please use only the black approved earpiece. The former grey earpieces must no longer be used. Please keep your earpiece away from all microphones at all times. When you're not using your earpiece, place it face down on the sticker on the table for this purpose. Thank you for your co-operation.

Pursuant to the order of reference adopted by the House of Commons last night, the committee is commencing its study of Bill C-64, an act respecting pharmacare.

As was indicated in the memo that was sent out this morning, I'd like to remind members that amendments to Bill C-64 must be submitted to the clerk of the committee by 4 p.m. Eastern Time tomorrow, Friday, May 24, 2024.

It's important for members to note that pursuant to the order adopted by the House yesterday, the 4 p.m. deadline to submit amendments is firm. This means that any amendments submitted to the clerk after the deadline and any amendments moved from the floor during clause-by-clause consideration of the bill will not be considered by the committee.

Colleagues, we also have a budget for the study of Bill C-64 that I propose to present to you after we hear from all the witnesses this evening.

Without further ado, I'd like to now welcome our first panel of witnesses.

We have with us the Honourable Mark Holland, Minister of Health. He's accompanied by officials from the Department of Health. They are Michelle Boudreau, associate assistant deputy minister, strategic policy branch, and Daniel MacDonald, director general, office of pharmaceutical management strategies, strategic policy branch.

Minister Holland will be with us for an hour, and the officials will stay on until five o'clock.

Without further ado, welcome to the committee, Minister. You can now go ahead with your opening statement for the next five minutes.

Fall Economic Statement Implementation Act, 2023

[Peter Julian, NDP, New Westminster—Burnaby, BC]

Mr. Speaker, I have a question for the member who just finished his speech. I would like to say at the outset that the number of Quebeckers already registered for the NDP's dental care program is in the hundreds of thousands. We also know that thousands of Quebeckers are getting their NDP dental care card every week. I think that is extremely important.

Pharmacare is another topic of discussion. All of the major unions in Quebec say that they view the NDP's pharmacare bill, Bill C‑64, in a very positive light. It is important to mention these two things. The NDP is the one proposing measures in the House to improve the daily lives of people across Canada. That is extremely important.

We are supportive of the fall economic statement, Bill C-59. I will talk about some of the measures the NDP has inserted into it, but I will start by saying that this is not an NDP budget.

Of all the governments in the country, the two most popular are the government of British Columbia and the government of Manitoba, and they are two NDP governments. They have both been very effective. The Manitoba NDP government is new, but it is extraordinarily popular. This is because the NDP really knows that the essence of good stewardship, of managing a democratic government, is ensuring that it is not the rich who are taken care of but, rather, regular folks. We have formed government provincially, of course, in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario and Nova Scotia. All those governments have been governments that have made a difference in the lives of people.

The simple reason the two most popular governments in the country right now are NDP governments is the financial statements that are issued by the federal ministry of finance. As members well know, the federal ministry of finance is not a hotbed of social democrats or democratic socialists, but it does publish the fiscal period returns. If members look through them, and I hope they do before the end of the evening, they will see that, over the last 40 years, the best governments, in terms of managing money, paying down debt, expanding education services, expanding housing services and expanding health care systems have been, systematically, over the last 40 years, NDP governments. That is why the two most popular governments in the country right now are NDP governments. It is because the NDP is not beholden to lobbyists.

The corporate Conservatives are run by lobbyists. Their national executive is run by lobbyists. There are lobbyists permeating the Conservative headquarters. The Conservative caucus and the campaign team are all lobbyists for the corporate sector. When the Conservatives were in government we could see how badly they performed. They do not understand the issue of stewardship. The infamous Harper tax haven treaties have bled over $30 billion, each and every year over the last 17 years, out of this country. That is $30 billion that could have been used for health care and housing. It could have been used for a variety of services for veterans, seniors and youth. It could have lowered post-secondary education costs. It could have made a big difference, but that was not what the Conservatives chose to do.

The Liberals, when they came to power, kept many of the tax breaks that had been given to the richest of Canadians, the wealthiest of Canadians, who have never paid their fair share, and the most profitable corporations. The NDP's approach is different, which is why the fiscal period returns to the federal ministry of finance show conclusively that the NDP and NDP governments are the best at managing money.

This is not an NDP budget, by any means. There are elements that the NDP forced into the budget that would make a difference in the lives of working people. The reason we are supporting it is the amendments we have achieved, in the same way that we brought dental care to Canadians. There are two million who have signed up already, including 100,000 seniors. There are many who are, for the first time in their lives, getting access to dental care, and this is just in the first two weeks of this new NDP program. NDP dental care is making a difference.

Earlier tonight, we moved the pharmacare bill to the health committee, which is where it should go. I am looking forward to those hearings over the next couple of days. People have been waiting for decades to have pharmacare added to our health care program and our health care strength in this country.

Mr. Speaker, you will recall in this House, as I am sure you have a great depth of historical memory, that 60 years ago in this House of Commons, just a few feet from this temporary house in the West Block, in Centre Block, Tommy Douglas, as the founding leader of the NDP, brought forward universal health care, which was viciously fought against by Conservatives at the time, who did not want to see people getting health care. However, it was a minority Parliament and Tommy Douglas was able to successfully deliver universal health care to Canadians.

Tommy Douglas always thought that we needed to make sure that health care was available from the tip of our heads right to the soles of our feet. He always envisaged that we would move to pharmacare, that we would move to dental care and that Canadians would have access to the full range of health care services that all other countries with universal health care enjoyed. Fortunately, we have the member for Burnaby South as our leader who feels the same way, and this has been a hallmark of NDP leaders over the decades. Every time there has been a minority Parliament, the NDP has stepped up as the worker bees of Parliament, as the adults in the room. We have gotten things done that have made a difference for Canadians, from universal health care to a whole range of other things like the Canada pension plan, employment insurance and all those things that make a difference in people's lives. All of them come thanks to the NDP, because that is our role in Parliament.

Therefore, when we look at the fall economic statement, we can see already that NDP stamp that makes a difference, but unlike the corporate Conservatives and the lobbyist Liberals, we do not believe in spending enormous amounts of money on the wealthy, on the pampered and on big corporations. We do not believe in funding massively the corporate sector. We believe in negotiating with the corporate sector. The reason we are pressing so hard for pharmacare is that countries that have universal pharmacare are able to have the bulk-purchasing negotiating power that forces down the price of drugs. New Zealand is a great example, where there is a reduction of 90% in the cost of certain medications because the New Zealand government was able to say to the pharmaceutical companies that if they wanted to come into that market, they would have to pay New Zealand's price. Currently, with the patchwork of plans that the corporate Conservatives and the lobbyist Liberals have put into place over decades, it is the pharmaceutical company executives who decide what the prices are, and that has to change.

The fall economic statement does contain some measures that we believe would make a difference. First off, we believe firmly in starting to adjust a taxation system that has become profoundly unjust and unequal. We have said that when we look at the infamous Harper tax haven treaties that cost us $30 billion a year, according to the Parliamentary Budget Officer, and we look at the range of other loopholes that exist, it is important to take steps to ensure that those loopholes are closed. The real taxation rate for Canada's largest corporations is single digits because of the loopholes. Because of the corporate executives' ability to write off and because of their ability to take money overseas where they do not have to pay taxes on it, their real taxation rate is in the single digits, less than 10%.

Why not ask Canadians what their taxation rate is? Middle-class Canadians pay their taxes expecting that they will get services and supports in return, but instead, under the Harper regime, we saw that the Conservatives slashed services to those taxpayers who had paid money into the federal government and they gave that money away. They gave it to tax havens. They gave it to the banks. Unbelievably, the Harper regime gave $160 billion to the banking sector so that the banks could prop up executive bonuses and corporate dividends.

The Conservatives have never apologized for that, and Liberals have never apologized for the $750 billion, again, in liquidity supports that they offered to the banking sector just a few years ago. It took 96 hours to provide $750 billion in liquidity supports. Between the two, the corporate coalition of Liberals and Conservatives, over the past 15 years, has given, unbelievably, in current dollars, over a trillion dollars in liquidity supports to the banking sector to prop up dividends and profits and executive bonuses.

We look at the health care problems that we are experiencing, the housing crisis and other problems that exist. We had, today, the member for Nunavut, who is an extraordinary member of Parliament, asking about day care that is not being adequately funded in Iqaluit, yet for Liberals and Conservatives, between them, giving a trillion dollars to the banking sector is no problem.

We can look at the tax havens over the last 15 years. That is half a trillion dollars. That is $30 billion a pop, according to the Parliamentary Budget Officer, given away to overseas tax havens without a penny of return to Canadians, yet we look at people with disabilities. Half of those who have to go to food banks to make ends meet, half of those who are sleeping outside in the parks and main streets of our country, are people with disabilities. They are not getting what they need in terms of support, but between Liberals and Conservatives, the corporate coalition, for 15 years, half a trillion dollars went to offshore tax havens.

We can look at oil and gas CEOs. Between both the Harper Conservatives and the current Liberal government, over the last 15 years, we have seen $100 billion given to oil and gas CEOs. There is a ton of money that goes to the wrong places in this country. That is why NDP MPs are here fighting on behalf of Canadians, delivering on pharmacare and affordable housing, finally. We had to push the Liberals hard on that over the last couple of years.

We are delivering on dental care, anti-scab legislation, a clean energy strategy and all those things, because, as worker bees in Parliament, we believe firmly that the investments need to happen with families and regular people right across this country, not the rich and the pampered. That is where the corporate Conservatives love to spend tons of money. That is where we have seen, sadly, the Liberal government spend tons of money. We believe that money needs to go to regular people.

When we look at this fall economic statement, there is a first step. Again, the NDP pushed hard for that. We finally will get an annual tax of 3% on types of digital services. This is earned by larger companies with more than $1.1 billion in revenue. This is an important step that we support. Again, is this an NDP budget? No. Does it take an important first step? Yes, it does.

As for the investments in housing, the apartment construction loan program, $15 billion, and the affordable housing fund over the next three years for non-profit and co-op and social housing, we support those as well. In fact, the member for Vancouver East fought hard and so did the member for Nunavut, to make a difference in terms of housing.

I do need to mention the anti-scab legislation for a moment and the work of my colleague from Rosemont—La Petite-Patrie, who did a remarkable job in making sure that, finally, replacement workers will be banned at the federal level, and Parliament will be called upon to get a final vote on that in the coming weeks. This is vitally important.

The NDP MPs work as a team. Our leader is the member from Burnaby South. We have made an enormous difference in this Parliament. We made an enormous difference in the last Parliament. We will recall, at the height of the COVID crisis, that it was the NDP that was pushing the government, fortunately in a Parliament where I think it is fair to say that all parties did work together, to invest more than $40 billion to ensure that people, families, people with disabilities, seniors and students were taken care of. Small businesses actually had the wherewithal to keep that shingle out as part of their small business by some rent relief.

All of those things came as a result of the NDP fighting hard on behalf of people. There have been two consecutive minority Parliaments where the NDP has made a difference.

Let me get to the crux of what is in Bill C-59 that we can support. The amendments that were brought originally by the member for Burnaby South, the leader of the NDP, would finally enhance the Competition Bureau. This is fundamentally important. We have had no consumer protection in this country. The corporate sector, the lobbyists, have really been paramount. We have seen, over the decades, how successive Liberal and Conservative governments have refused to do anything to enhance consumer protection.

The member for Burnaby South, the national leader of the NDP, brought forward enhancements to the Competition Act that would ensure that we can crack down on food price gouging and gas price gouging that we are seeing. It has happened with impunity because the Competition Bureau has not had the tools to take action against it. Members will recall that the member for Burnaby South tabled a bill in this regard. The NDP fought hard. We negotiated hard. We did our work as the worker bees in Parliament.

As a result of that, many of the enhancements to the Competition Act are now in this legislation. This is important because despite the protestations of the member for Carleton, who tries to pretend that putting a price on pollution has led to the difficulties and challenges around the rise in food prices, we know that most Canadians understand, unlike the member for Carleton, that it is actually food price gouging that has taken place. We are seeing massive profits in the grocery industry. We are seeing record CEO bonuses.

We have a Conservative Party that is absolutely inundated with lobbyists. Lobbyists run its national party and run its campaign team. This is no surprise because of all the corporate Conservatives have done. Their past track record is giving massive amounts of money to the corporate sector, without ever asking for anything in return. It is like they are not even trying to get any benefits for Canadians. They just hand it out. There were the infamous Harper tax haven treaties, $30 billion each and every year handed over to the wealthiest of Canadians in the corporate sector, and they never asked for a thing in return.

The role the NDP plays in Parliament is so important because the Competition Act amendments that we brought in would mean that we could start cracking down on the egregious food price gouging Canadians are experiencing when they go to the grocery store, and gas price gouging. Just a few weeks ago, my colleague from Courtenay—Alberni signalled this. I know my colleagues in British Columbia, like my colleague from South Okanagan—West Kootenay, can attest to this. The prices in British Columbia all of a sudden skyrocketed by 30¢ a litre. There was no explanation because the companies can do that now. They can do gas price gouging.

The companies do this when we have peak season in terms of travel in British Columbia. It is a beautiful province. We like to get around in British Columbia. The gas companies can gouge with impunity because the Conservatives have allowed them to do this and the Liberals have allowed them to do this. Finally, with these enhancements, the Competition Bureau and the Competition Act would be able to crack down on this gas price gouging that has inflicted so much pain on British Columbians and Canadians right across this country.

These are two important elements that are part of this bill, and it is why we are supporting it.

I wanted to give a shout-out to my colleague from London—Fanshawe. She presented a private member's bill waiving the GST on counselling and psychotherapy. The NDP has also put that into this bill. That would make a difference for all those who need counselling and psychotherapy. Those who have experience with mental illness, mental challenges and mental health know how important it is to be able to pay for those services. This is another innovation that would make a difference.

The NDP has achieved a lot to improve the bill, and we will support it.

Consideration of Government Business No. 39

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, just to confirm, now that the motion has passed regarding Motion No. 39, I lose my unlimited time and I now have a 20-minute slot. Therefore, I will have to share my time with the member for Cumberland—Colchester, even though I would have enjoyed continuing to speak to an issue that I hold very dear to my heart, which is the approval of drugs for rare diseases in Canada and how patients can get access to them. Those two words actually only appear once in the legislation.

People with a rare disease are some of the most needy patients in Canada. As I said during the debate on Bill C-213 back in 2021, the hardest medication to get in Canada is the one that is not approved and not available because the manufacturer will say that Canada is too complicated, too difficult and it is not worth its time to try to get it onto our market. That is because of all the regulatory hurdles and steps that exist that make it very difficult for patients with rare diseases to get access to the drugs they need.

We saw this with cystic fibrosis drugs for patients who were trying to get access to Trikafta. It took many years from the time when it was available to patients in America to when it was available in Canada, and it was regulatory hurdles that made it much more difficult to do so.

Now that the government has passed this gag order on the gag order, it will direct the Standing Committee on Health on how it will consider the matter.

I want to draw the attention of the House to the debate on May 6, page 23051, where the Minister of Health responded to a question from the member for Berthier—Maskinongé about the timelines and why the Liberals were limiting debate. At the time, the minister said, “ there will be time for the committee to conduct a study.” I would put to members and constituents back home that a potential 10 hours of witness testimony at a committee is insufficient time to consider this pamphlet of a bill that the NDP-Liberal coalition is pretending is pharmacare. I have read the legislation in full, so I will comment on its contents as well.

The minister went on to say, “Yes, it is important to debate. However, there is plenty of time for debate in committee and during the rest of the House process. It is time to get on with it and move forward.” With this programming motion, the Liberals have essentially ordered the MPs on the committee to only consider it for a few more hours and then send it back here. In fact, after this bill has passed, there is now only one more day left for amendments to be considered. How can amendments be proposed without hearing from officials and witnesses who might bring forward amendments that would be of value to be considered by parliamentarians on that committee? It seems this is completely backward.

I want to comment on the issue of Conservatives delaying the bill, because this is a favourite talking point now of the Liberals and their colleagues in the NDP. I want the member for New Westminster—Burnaby to pay close attention to this. The bill was tabled on February 29. I would suggest that almost three and a half years into this mandate, this bill was not a priority of the government. Second of all, this bill was considered on April 16, May 6 and May 7, three days of consideration by the House of Commons. There were secret negotiations held between the Minister of Health, because he actually said it on the record, and whichever person on the NDP side who was negotiating so they could cobble together this particular piece of legislation.

I would put to members and my constituents back home, who deeply care about patients with rare diseases like I do, that there is nothing in this particular piece of legislation for them. It is not the job of the House of Commons or members of Parliament to simply ratify a secret deal reached between the Minister of Health and the NDP negotiator or negotiators. Our job is to debate, to bring forward ideas and potential amendments from expert witnesses, stakeholder groups and individuals back in our ridings who deeply care about this issue.

I will also mention that although Quebec has been mentioned several times, there is another province that has said openly it will not participate in this pamphlet of a pharmacare plan. It is Alberta, where I am from. Successive ministers of health have said they will not participate in it. One of the talking points I have heard is that we have a patchwork system right now in Canada. Saying “patchwork” is a way to kind of denigrate the hard work of the public servants in the different provinces in Canada who work for these public insurance plans. They are all over.

In fact, in Alberta, Blue Cross is available to anyone who wants it. There are lots of different public insurance plans. There are lots of public servants who work for them, and they work very hard to make sure they cover as many Albertans as possible. My province has said no and Quebec has said no, so we still have a patchwork. Even if this bill passes, even if it were to follow through on all the principles, the highfalutin language that I hear from the Liberals and the NDP on this, there will still be a patchwork in this country. We cannot force a province to participate.

As clause 6 of the pharmacare legislation clearly states, nobody's medication will be paid for. There are separate agreements that would have to be reached with each province. It says very clearly in subclause 6(1) of the pharmacare legislation, “in order to increase any existing public pharmacare coverage”. That would suggest that every single province has to either create or drastically expand a plan or successive series of plans that are single-payer, because that is one of the principles referred to again in that section.

If a province does not do that, it cannot negotiate a deal for future medication to be covered. No medication will get covered for either diabetes or contraceptives when this legislation passes. There will be none because no agreements have been signed yet. Alberta has said no, Quebec has said no, but the patchwork will continue.

I will move on to the legislation as I do want to mention this. Like I said before in a prior debate, there is a Yiddish proverb I used after listening to the minister's speech when he introduced Motion No. 39. He seems to think that pearls flow from his mouth because when I compared his speech at second reading on pharmacare, Bill C-64, and his speech on Motion No. 39, they were almost identical.

The minister actually used the exact same three anecdotes to make the case for why this plan is necessary. In the summary of the legislation, when the contents are reviewed, it gets into a lot of areas of provincial jurisdiction. This should be exclusive provincial jurisdiction. It is starting to interfere with how the provinces manage their public health care plans.

I will mention here that nobody with a rare disease will be covered by this piece of legislation. Nobody will be covered, whether someone has phenylketonuria, PKU, whether someone has cystinosis and needs Cystagon, or whether someone has MS, which is, I would say, the most common rare disease in Canada. None of their medication will be covered. If someone's kids have a rare disease, or a family like mine has Alport's syndrome, none of their medication will be covered by this piece of legislation.

The “Funding commitment” in clause 5 reads, “beginning with those for rare diseases. The funding for provinces and territories must be provided primarily through agreements with their respective governments. Then it goes on to talk about “payments” in clause 6 and completely contradicts clause 5 because it says, “for specific prescription drugs and related products intended for contraception or the treatment of diabetes.” In fact, there will be no payment plan for anything else. There cannot be because this legislation will not do any of those things. Nobody with a rare disease will be covered once this legislation passes.

I have been, I hope, consistent in this place about rare disease patients for the past nine years. That is the focus of my opposition to national pharmacare because it will not help them. Like I said, the hardest medications to get in Canada are the ones that are not approved in Canada. All the changes the government has done to the Canadian Agency for Drugs & Technologies in Health, CADTH, as well as all of the changes made to the Canadian Drug Agency, the PMPRB and the PCPA have been repetitive. The same mistakes are being repeated here.

The government says it is going to do bulk buying. Bulk buying is already done. It is done by the provinces through the PCPA. The government has an agreement for generics as well, which are not covered in this particular piece of legislation. There is no direct reference to generics. There is no direct reference to patented medication. It does not talk about those things. It takes years to get those drugs approved in Canada.

I would put to members and my constituents back home, who have emailed me because they are all so worried about this, that this is a pamphlet of legislation. The substance will be in the agreements that may come in the future. There are already two provinces that have backed out and other provinces are considering doing the same. Why is it that, since 2019, when the government announced it was going to fund drugs for rare diseases at $1.5 billion, it has done nothing? Not a single medication prescription has been filled for anyone I know with a rare disease in Canada. That money is just sitting there. The government has only started to put out RFPs to consider creating registries for rare disease patients. Registries, not medication. Most of the money remains unspent. The government has not done anything. That is the same thing that will happen here: a series of broken promises, unkept promises. The Liberals are being helped by the NDP to do this, giving people false hope.

I tell people who enter my office that the last thing I want to do is give false hope. I have two serious rare diseases in my family. Families who have rare diseases like mine cannot wait for the government to get its act together again.

Motion That Debate Be Not Further Adjourned

[Elizabeth May, Green, Saanich—Gulf Islands, BC]

Mr. Speaker, I am all in favour of the purpose of Bill C‑64, but I take issue with rushing through the work, because we must participate in the debates.

I really wish we had time. I understand the pressure, as things in this place seem to face so many obstacles. The concern of the government is that things will get bogged down

As the leader of the Green Party, we have been, in every platform for I cannot remember how many elections, calling for a universal single-payer pharmacare that actually means that Canada will properly be a country with universal health care. We are the only country in the world that has a nationalized health care system that does not provide for universal pharmacare.

The big pharma industry in this country, and globally, makes indecent levels of profits over drugs that it has not had to put investment in for research. There are a lot of issues to discuss with pharmacare. The Hoskins report scratched the surface of the ways we could, in this country, save billions of dollars for our health care system, but not with a piecemeal approach. I very much fear the piecemeal approach to what I support: absolutely, diabetes medications, absolutely, contraception available for free. However, I fear that we may be setting up a system where, because we do not see savings, we may even see an increase in costs.

Universal, single-payer pharmacare would save our health care system billions of dollars a year, and this is not it, not yet. I want to support getting the bill through, but I really object to seeing a constant loss of our opportunity to thoroughly debate issues because of the need to bring down le bâillon, toujours la guillotine.

Government Business No. 39—Proceedings on Bill C-64

[Tom Kmiec, Conservative, Calgary Shepard, AB]

Madam Speaker, I listened attentively to what the health minister was saying, so I am glad to be the first person to rise on my side to maybe provide a rebuttal and also to reset the debate, because the debate is not directly about Bill C-64; it is about a programming motion.

When I listened to the minister's speech, I also had the time to compare it to his speech that he gave at second reading. The same three anecdotes he raised today were raised then. Two of the three are completely misleading, and one was a very personal experience of his that he raised, which is his right as a member and a minister.

However, this is about a programming motion that would guillotine debate in the House. It would order a committee of the House to basically consider a bill within 10 hours, a bill that would have profound impact on the structure of Canada's health care systems, plural because they are systems. Quebec has a different system than Alberta, than British Columbia, than Saskatchewan and than other provinces in Canada.

We know from much research that has already been done by CIHI, The Conference Board of Canada, Statistics Canada, and CLHIA, which is the life insurance trade association, that 97.2% of Canadians already have access or are eligible for access to an insurance benefit plan of some sort. I know that in my home province, we have Blue Cross, which is usually the insurer of last resort that provides a lot of the services that the minister talked about.

The worst part of all is that we would be programming a committee of the House to study what essentially amounts to a pamphlet of legislation. The minister talked about finding common ground and solutions. I have also heard other members of Parliament talk about how important committee work is to them. Now we would basically be guillotining and gag ordering a specific committee of the House, the Standing Committee on Health, to do its work in 10 hours.

That is why I asked a question for the health minister on why he felt the need to exclude himself from having to come to testify before the health committee. One would think that he would put himself before the members at committee and answer all of their questions on the reasoning behind C-64 and the wisdom of it, because it is not a national pharmacare plan. That is not what it would do. It would cover two very small areas of medicine.

I will note that in the minister's second reading speech about Bill C-64, he had all of one sentence devoted to rare disease drugs and rare disease patients, typically the source of the most expensive therapies, the most expensive drugs, on an individual basis, not on a broad basis. Typically most drug plans in the provinces, whether private or public, spend the most on things like the very basic medication for infections. Medications like amoxicillin or penicillin and variations thereof are the ones that are quite expensive because people get a lot of infections, so it it just a question of volume in those situations.

There is a lot of medication out there that is expensive because it is brand new; it is coming onto the market for the first time. Recently I learned about a new oncology drug that is going to be made available in the United States, but it is cutting-edge, specialized medicine made for the individual patient. The drug comes with a few tens of thousands of dollars of cost associated with its delivery. There will be some cancer centres in Canada that will not be able to have it available for patients, but it will be available to other patients in other parts of Canada. Oncology drugs would not be covered under the plan.

There would actually be nothing covered in the plan except for those two areas of medications, which are very specific ones as well. Like I said, there would be nothing for rare disease patients. The minister talked, in his original speech at second reading, though not today, about the $1.5 billion being devoted to rare disease drugs. That announcement was made in 2019, yet only now has some of the spending gone out, not to cover drug costs but to cover things like the creation of rare disease registries to get foundations, universities and private organizations to start up a rare disease registry specific to one individual drug.

There is often a problem in how the Liberals propose things. They say something, make claims, and then it takes years before anything actually happens. As an example, in 2019 there was an announcement. In 2024, still not a single rare disease drug has been covered by the $1.5 billion. It took five years of waiting. Rare disease patients cannot wait. In fact it was the Liberal government that cancelled the original rare disease strategy in 2016. At that time, the president of the Canadian Organizations for Rare Disorders, Durhane Wong-Rieger, said that it was the kiss of death for patients with rare diseases.

She is a literal ball of energy and an amazing woman, an amazing advocate for patients with rare diseases. This was in 2016. It took the government three years just to announce funding and five years after that to roll out a single dollar. Now the government wants to convince us that it needs to expedite Bill C-64 by programming and ordering the Standing Committee on Health to consider certain things but not others.

I will go through the programming motion, since the minister did not feel the need to even explain why this was necessary. He repeated, essentially, his second reading speech on why we need to expedite this so quickly. There were three days of debate in the House before there was a vote at the Senate and in the Standing Committee on Health. I looked at the work the Standing Committee on Health had done. It did not even have the chance to consider the bill. That is how quickly the government is now programming what is going on.

The first line of this programming motion is very simple: “the committee shall have the first priority for the use of House resources for the committee meetings”. It seems quite reasonable that it would be given first right to interpretation, rooms and catering services if the committee is expected to sit for hours and hours on end. I guess a programming motion would have to have that in it.

The second part is, “the committee shall meet between 3:30 p.m. and 8:30 p.m. on the two further sitting days following the adoption of this order to gather evidence from witnesses, provided that any meeting on a Friday may start at 12:00 p.m. for a duration of not more than five hours”. Essentially, that is saying there will be two more meetings of the Standing Committee on Health and 10 hours of testimony. There are countless members in the House who will say that, during consideration of a bill, witnesses will testify, explain an idea or perhaps a missing amendment or particular line in a bill between the French and the English, which happens on a fairly regular basis. They either do not match, do not make sense or there could be more added to a bill to clarify or constrain a bill. Ten hours is simply not enough for a bill that would have such a substantive impact.

According to the health minister, the Liberals are going to celebrate a bill with such a substantive and profound impact as some great achievement. I do not believe that. I believe this is a pamphlet. This is not national pharmacare. There is no spending associated with this bill. Every one of my constituents back home knows there is no spending associated with this bill. If the Liberals keep ramming the bill through at this pace and it passes through the Senate at some point in the future, not one single drug will be paid for through this legislation because there are no dollars associated with it. There is no, what we call, ministerial warrant from the Minister of Finance connected to this bill. There will be no medication paid for through this particular bill. That is why I do not understand why this programming motion is of such necessity when the committee has not even had a chance to consider it.

I understand perhaps it would be easier to tell Conservatives, members of the Bloc and independent members that they are slowing down the committee's work, that they are not allowing the committee to proceed with witness testimony or consider the contents of the bill, but that has not even happened yet. We have not even had a chance to invite witnesses to explain to us their views on the contents of the bill.

When the minister talks about finding common ground and solutions, he accuses the Conservatives of being against it. Of course we are against it. We voted against the bill, but that doesn't mean we cannot improve an F product and make it maybe an F+ product. I know that is not a grade in universities or colleges in Canada, but we can always make something terrible a little less terrible. This is essentially, like I said, a pamphlet. For me, it was easier to vote against it because I saw nothing for patients with rare diseases. That is not a surprise to anyone in this place.

I remember the original debate on an NDP private member's bill, which I believe was Bill C-340, if memory serves. It was on national pharmacare. At least the title was on national pharmacare, not the contents. It was put forward by the member for Vancouver Kingsway. He and I debated it for most of the day. I was all about access for patients with rare diseases, and I said that was why I could not vote for that bill at the time.

It is not a big surprise to many members of the House and members of the other place that I would be against a bill that has has a title of national pharmacare, but would not do anything for patients with rare diseases. Members know of a personal anecdote I have mentioned many times in the House. I have three living kids with a rare disease called Alport syndrome. One daughter passed away very young, at 39 days old, with a different rare disease. I always joke with my friends in the rare disease community that I am due. I should probably play the lottery as I would I have a decent chance of winning because both of those conditions are rare.

In the case of my living kids, it is a rare disease of the kidneys, CKD, a chronic kidney condition. In the case of my youngest daughter who passed away, she had Patau syndrome, which is a chromosomal condition and very, very rare.

If one knows a child with Down syndrome, one should hug them. They are very special little kids. My daughter had a condition that is considered much worse than Down's. Down's is survivable. There are a lot of very sweet kids who live with Down syndrome, and their families are made incredibly happy by them because they are sweet into the teen years, into their twenties, thirties and forties. One never has to go through those teenage years, as I am going through right now with one of my kids, where suddenly, as the dad, I know nothing and they know everything, which is okay. I will go through this three times in my life.

I will move on to the next part of the programming motion, which reads, “all amendments be submitted to the clerk of the committee by 4:00 p.m. on the second sitting day following the adoption of this order”.

We are quite fortunate there was unlimited time provided, I believe, for the first two speakers on a programming motion. Perhaps members are surprised I would rise on this, but I intend to use this time to explain why I do not like the programming motion and the defects with Bill C-64, and to remind the minister about what the summary of his own legislation says that it does, because it is the complete opposite of what the minister just explained to the House. It is the complete opposite from his second reading speech as well, so members can stay tuned for that part.

On these amendments, we are fortunate because we have a constituency week coming up. I can guarantee many of us will be sitting down and working with patient advocacy groups. We will be going to our stakeholder groups and meeting with our constituents. I have a few who have emailed me on this subject. I will be finding useful amendments to this bill that would improve it in my eyes and in the eyes of my constituents. We have the time.

Had we had a sitting week coming up, had there not been unlimited time for the first speaker on the official opposition side, we could have been rushed to provide amendments by 4 p.m. after the first day. That is an incredibly low amount of time considering this first came to the House February 29 and then the last vote was on April 16 before it was sent to the committee.

Doing a programming motion like this, or a gag order to the committee, is wrong. I do not agree with programming motions. I believe I voted against nearly all of them that ever came through the House. I believe the health minister was also the House leader at one point when Motion No. 16 was being moved through the House. There was also a previous one, and I believe it was a member for Waterloo who moved Motion No. 6, which would have programmed how committees work in the Standing Orders forevermore for the Houses.

I cannot base our opposition or our support for any particular motions and programming motions on good faith coming from that side because I simply do not believe the cabinet, the front-benchers. I do not believe them. There are many good-hearted backbenchers in the Liberal benches. They are easier to work with, I find, than those on the front bench. The front bench I just do not trust. I do not trust the front-benchers to do the right thing for Canadians. In fact, Canadians do not trust them. If we look at the polls, there is about a 20-point disparity, depending on which poll we consider, between what the government is polling at and what the official opposition is polling at.

I will move on to the next point, which reads, “amendments filed by independent members shall be deemed to have been proposed during the clause-by clause consideration of the bill”. I actually do not have a problem with that. Independent members should be treated like every other member of the House, especially during considerations of bills.

Now comes the next one, which gets gets quite technical:

the committee shall meet at 3:30 p.m., on the third sitting day following the adoption of this order to consider the bill at clause-by-clause, or 12:00 p.m. if on a Friday, and if the committee has not completed the clause-by-clause consideration of the bill by 8:30 p.m., or 5:00 p.m. if on a Friday, all remaining amendments submitted to the committee shall be deemed moved, the Chair shall put the question, forthwith and successively without further debate on all remaining clauses, amendments submitted to the committee as well as each and every question necessary to dispose of the clause-by-clause consideration of the bill, and the committee shall not adjourn the meeting until it has disposed of the bill...

This means that, once the 10 hours of testimony are done, once that particular portion of the committee's work is done, every single amendment has to be voted on immediately, with no debate for amendments. In those 10 hours, if witness testimony takes five or six or seven hours, we then have a few hours left over to consider and debate amendments. We could not even persuade the other side of the wisdom of the amendment. This is so profoundly wrong. I see this programming motion all the time when it comes to omnibus budget bills.

I will remind the House that the Liberal platforms in 2015 and 2019 promised not to do omnibus budget bills, yet they have done them repeatedly, over and over again. In fact, in Liberal budget 2023, they had section changes to clauses 500 to 504 on natural health products. That has nothing to do with the budget. There are no spending items related to it, but it was a regulatory expansion to apply rules for pharmaceuticals directly onto natural health products.

It caught a lot of people by surprise, including myself, that in a budget bill, which sometimes has hundreds of pages, one would do such a thing. They basically clip what they usually do at the finance committee, and now they have dropped it and ordered the Standing Committee on Health to do it in one particular way, in their way, their preferred way, with no debate on any amendments.

Why should one allow backbenchers from any of our political parties to freely consider the judgment and the argument being made by another member of another political party, individually or on behalf of their political movement, on the wisdom of a particular amendment to a government bill? I know, it would be shocking to even have that consideration.

It would be even more shocking for some members of the government benches to know that I have voted for government amendments at committee. I know. I hear “shame” from my side of the benches, but it happens. Sometimes they have a good idea. I am willing to consider good ideas. I am willing to. I have been on several committees over my time, from foreign affairs to finance to the Standing Joint Committee for the Scrutiny of Regulations. I am on the immigration committee and the Canada-China committee now, the select committee. I will vote for reasonable amendments. I will even talk to my own side to try to convince them if there is a reasonable, logical amendment that makes sense. Sometimes there is an argument made by a member of another party that actually makes sense. This section prevents that. There will be no debate on amendments. One is just supposed to vote on them.

Of course, what will happen is that there will be a question of having a recorded division on every single one of those votes. This means the committee will continue, likely, late into an evening, because it is basically programmed. To demonstrate that this is wrong and should not be done, I am fairly sure that there will be members of the committee who will want a recorded division on every single item so that we can go back to it later with our errors and mistakes and illogical situations that arise because two sections perhaps conflict with each other. This type of amendment process, clause by clause, is incredibly important, and we now will not be allowed to be given this opportunity.

The sixth portion of this guillotine gag order on the Standing Committee on Health says:

a member of the committee may report the bill to the House by depositing it with the Clerk of the House, who shall notify the House leaders of the recognized parties and independent members, and if the House stands adjourned, the report shall be deemed to have been duly presented to the House during the previous sitting for the purpose of Standing Order 76.1(1)

This is a fairly reasonable amendment that is often provided by members in other committees to make sure that, when reporting on a bill, the House leaders are informed, typically to go on the Notice Paper. I do not have a direct issue with this particular portion, apart from the fact that this is a programming motion, a gag order, that is going to guillotine a committee of the House without that committee even having had the chance to consider a bill.

The next section is section (b). It says:

not more than five hours shall be allotted to the consideration of the bill at report stage, and at the expiry of the time provided for the consideration of the said stage of the bill, or when no member rises to speak, whichever is earlier, any proceedings before the House shall be interrupted, and in turn every question necessary for the disposal of the said stage of the bill shall be put forthwith and successively, without further debate or amendment, and, if a recorded division is requested, the vote shall not be deferred...

It continues. There is another one, but I am going to stop right here. This essentially means that, when amendments come back from committee, they are sometimes ruled out of order. They cannot be considered at committee but they can be considered by the House because the House has control of its committees, and the House can decide whether certain amendments can be voted on. Those are typically then submitted to the Speaker.

This essentially says that this process will also be guillotined after five hours. I know they love gag orders. I know they love to guillotine debate. My hope is, too, that during this debate on the programming motion, they do not gag order the gag order. I would hate to see that. It would be like a double gagging of the orders of the House and really limiting debate.

They have done it before. They have done it on Bill C-7 and Bill C-14, the two medical assistance in dying bills. At different stages of those bill, they both programmed and then shut down debate on them. I have seen, plenty of times, allocation motions being moved by cabinet to force bills through the process on matters of conscience.

It is not as if they are technical bills where perhaps there is timeline the Liberals need to reach and where, for the proper administration of government, they can perhaps make an argument they can stand on, but for matters of conscience, to guillotine debate is wrong. In this particular case, I would say that this is not a matter of conscience. I think this is about administration of government services and what the contents of the bill are actually about versus what they are not about. When the Liberals impose a guillotine with time allocation and force the closure of debate, the major disadvantage to Canadians is that they cannot prepare themselves. They cannot organize themselves when they are opposed to particular ideas and when they want to ask questions like, “Why is my rare disease, my health condition or MS not covered in this bill? Why is diabetes covered?”

I know a lot of diabetics, and I am not picking on them directly. I am just asking a simple question. The most common rare disease is multiple sclerosis, or MS. A lot of people in my family have it, as well as friends, colleagues and co-workers. There are spouses of members on this side who have it. Therefore, why is that particular condition, and its medication, which is expensive medication, not in this particular piece of legislation?

It is a choice the government made, so why can we not debate that choice the government has made for those two particular conditions and the medications associated with them? If they are being covered, why not others? There are so many other types of medications, such as the most common ones: penicillin, amoxicillin and all the variations of the “-cillins”, because there are so many of them. Why are they not covered in this particular piece of legislation?

On this programming motion, should we put forward such an amendment to be considered at committee? If it is deemed non-votable at committee, why can it not be considered at report stage?

I guess I will only get through the programming motions, and I will have to come back later to finish talking about Bill C-64 and some of the things the minister said, as well as my concerns with the PMPRB, CADTH, pCPA and the entire architecture of drug approval in Canada.

The motion reads, “not more than one sitting day shall be allotted to the consideration of the bill at the third reading stage, and 15 minutes before the expiry of the time provided for Government Orders”, and it goes on like that, which basically means that there will be one day for final speeches, and then it will be done and sent to the other place. It is wrong to ram through a bill in this method, with bad faith being shown by the health minister, claiming that we were opposing it and not willing to consider things, when he has never bothered to listen.

[Mark Holland, Liberal, Ajax, ON]

Madam Speaker, through you to the Conservatives, they are against this bill and against providing contraceptive and diabetes medications. That is fair. They can be against it, but the House has an elected will. What we saw on the very first day that we attempted to put this bill before the House was obstruction and what we have seen with other bills is obstruction, not obstruction to continue a conversation, but obstruction because they do not want it.

I do not know how long we could have a debate about whether or not we should do it. What is the value of that debate to public discourse? We could talk about it until the cows come home, but Conservatives are against it. There is going to be an opportunity obviously at committee, at third reading and at report stage to have a lot more debate on the bill, Bill C-64, and to hear their single position, which is in opposition.