Evidence of meeting #34 for Health in the 41st Parliament, 2nd Session. (The original version is on Parliament’s site.) The winning word was clause.
A recording is available from Parliament.
NDP
Libby Davies NDP Vancouver East, BC
Just to clarify, our intent with the motion is that it allows the Governor in Council to work with other affected parties. For example, it could be provincial governments, it could be health authorities, it could be research institutes. The focus here is about communicating in terms of best practices and so on.
I don't know if that clarifies it for Mr. Lee.
Director, Office of Legislative and Regulatory Modernization, Policy, Planning and International Affairs Directorate, Health Products and Food Branch, Department of Health
Thank you for the explanation.
When you're making regulations under this kind of section, because it is up under the criminal head.... Usually the recipe you have to use is that you make a prohibition—make something criminal—and then sort of allow it. Around things like best practices for risk communication, certainly we would encourage that, but touching that area with a criminal pen is a serious movement.
To be honest, we're trying our best to understand how this would work. We understand some of the principles, and we would certainly agree that talking to physicians and our colleagues in the provinces about best practices is something that Health Canada would want to do, but in a regulation it's not something that we would normally envisage doing.
Conservative
The Chair Conservative Ben Lobb
Is there any other discussion on amendment NDP-7?
Seeing none, I'll call the question.
(Amendment negatived [See Minutes of Proceedings])
Next up, we have amendment NDP-8.
NDP
Libby Davies NDP Vancouver East, BC
Mr. Chair, this amendment deals with disclosure. It's a subject that's come up quite a few times, both in terms of this bill and in our previous study looking at abuse of prescription drugs and the whole system of disclosure, how decisions get made, and how prescribing practices happen.
This amendment would add, after line 11 on page 7, the following:(f1) respecting the procedures for disclosing gifts or other advantages offered to or accepted from the holder of a therapeutic product authorization or the manufacturer of a drug or device, for limiting the value of such gifts or other advantages and for addressing any conflicts of interest involving the holders of a therapeutic product authorization or the manufacturers of a drug or device.
This amendment, if it were approved, would allow the Governor in Council to submit regulations requiring public disclosure of payments to physicians, medical institutions, colleges, and so on.
This amendment is based on the idea of what already exists in the United States, which is called “sunshine” legislation. In the U.S., manufacturers of drugs, medical devices, and biologicals, working with the U.S. government, actually have to report any payments and items of value over $10 given to physicians, physician associations, medical institutions, etc.
We're not suggesting that this would exactly follow the U.S. legislation, but we think the principle is really, really important. It should be covered in this bill.
So we're not suggesting the specifics of the U.S. legislation, but we do identify that this is an area where further regulations are needed. Possibly Mr. Lee or Mr. Edwards will say that there's a question of jurisdiction here, that it pertains to provincial jurisdiction, but we believe it could be spelled out that if it involves any company or corporation or business that works with the federal government, then it would under federal jurisdiction.
We offer it in that spirit.
Conservative
Terence Young Conservative Oakville, ON
Mr. Chair, I want to thank Ms. Davies for this initiative.This is a big problem; there is no doubt about that. The debts of gratitude created in our health care professionals by pharmaceutical companies giving them everything from pens to coffee cups to free lunches to free trips, just goes on and on. And it's proven by research to influence prescribing practices.
The Canadian Medical Association should do this voluntarily. They haven't, obviously. My concern is that this isn't related to the safety of a therapeutic product directly, and it could possibly be challengeable because it's not fully under federal jurisdiction, although that's not my primary concern. This bill is about the safety of therapeutic products, and as such is outside the scope of the bill. If the member introduced a private member's bill on this, I'd be happy to support it.
NDP
Libby Davies NDP Vancouver East, BC
I don't know if it is outside of the scope of the bill. I don't believe it is, and I have suspicions as to what Mr. Lee and Mr. Edwards are going to say, but maybe they could respond to that because it relates to any company that works with the federal government, so that jurisdictional question is clear.
And I do think it is related to safety because we heard very clear testimony that this whole chain of events has to do with prescribing practices. When physicians and others get all this free stuff and they get information that's possibly not correct or misleading and they go to these so-called educationals, we heard about it all. When they see ads in the medical journal that are just ads, promotion, and on that basis they're making very important decisions that affect the health of their patients, I believe it is related to the issue of drug safety and it's related to how people are practising.
I'd like to ask Mr. Lee or Mr. Edwards their opinion on whether or not it's within the scope of the act.
Director, Office of Legislative and Regulatory Modernization, Policy, Planning and International Affairs Directorate, Health Products and Food Branch, Department of Health
Thank you.
I don't want to fulfill your prediction, but we do worry. We walked through this to see what kind of regulations could be made. You would have to have a prohibition on the receipt of a gift of a certain nature, then you'd have to make a rule that says you have to report it in this way. That would be the federal structure, at least that seems to be what this would intend.
The problem with that is then there's a federal rule telling doctors how to behave and when they get a gift, what to do and how to report it. And that's a very difficult ground for federal jurisdiction, so we tried to think this through.
Mr. Chair, when the member says “works with the federal government”, is it regulated by the government or a government corporation?
NDP
Libby Davies NDP Vancouver East, BC
It has some working relationship in that they have to report, there's oversight by the federal government, there's some connection between the companies involved who would be covered by this because they are reporting to, they're under the jurisdiction of, the federal government in terms of regulation.
NDP
Libby Davies NDP Vancouver East, BC
Could I also ask the legislative clerk his opinion on whether or not this is within the scope of the bill?
Conservative
The Chair Conservative Ben Lobb
I've asked him too.
If you go to the part where it talks about conditions. That would be in paragraph (b). Potentially it could be a condition. So it may be a stretch, but we won't rule it out of order.
Is there any other discussion or debate on NDP-8?
NDP
Libby Davies NDP Vancouver East, BC
Can I just be clear? This is about reporting by the manufacturers, not the doctors. The onus would be on the manufacturers.
Conservative
The Chair Conservative Ben Lobb
We'll have a recorded vote on NDP-8.
(Amendment negatived: nays 5; yeas 4 [See Minutes of Proceedings])
We had a motion when we came back from votes that clearly indicated we would go until a quarter to 2, and then we would come back at 3 p.m. I think at this point that's what we should stick to.
NDP
Libby Davies NDP Vancouver East, BC
I know we passed a motion stating 3:30, but I'm trying to make a flight out. I'd be happy to come back.
If we are going to be in Centre Block, which is a lot closer, I would be happy, if others are agreeable, to make it 3:15, assuming that question period has concluded—I know sometimes it goes a little bit over—just so we have the extra 15 minutes.
Conservative
David Wilks Conservative Kootenay—Columbia, BC
Thank you, Mr. Chair.
Just to bring some clarity to this as well, there are two votes after QP.
Conservative
The Chair Conservative Ben Lobb
I want to remind everybody, just as Ms. Davies said, that we're going to meet back at Centre Block in room 253-D. Bring your paper with you and bring a sandwich with you, because we're not coming back here.
Conservative
The Chair Conservative Ben Lobb
Yes. We'll pick up at amendment CPC-10.
I'll suspend the meeting. We'll see you as close to 3:30 as possible.