Health Committee on May 28th, 2019

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you. I appreciate that.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

—without putting any pressure, of course, on them. I am happy to have that conversation with the senators I know.

Again, I truly feel that your private member's bill would make a significant difference, and I was very pleased that we were all able to support it.

[Len Webber, Conservative, Calgary Confederation, AB]

We just have to get it to pass, and I have worries.

Anyway, thank you.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

My question probably is not a surprise.

Health Canada is responsible for the cannabis regulations that were put forward, and I have received numerous complaints from all over the country. I'll give you some of the locations: Aldergrove, Dufferin—Caledon, Kawartha Lakes, Clearview Township, King Township, North Dundas, Aurora, Leamington, Vanastra, Clinton, Tay Township, Severn Township, and a number of others.

Basically, the complaints are about odours coming from people's growing operations, security there and people growing more plants than their licence actually will permit. Calling the 1-800 number at Health Canada is not effective. I've been escalating these complaints as high as Simon Kennedy, and I know he probably has some specific answers on these. Still, Health Canada does not appear to be enforcing the regulations, and the police say they can't enforce Health Canada's regulations.

When is Health Canada either going to enforce the regulations or inspect and remove the licences of the people who are not adhering?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Ms. Gladu, thank you very much for your question. I'm not surprised that you're asking it today.

We all recognize that our government has committed to putting together and delivering a legal and regulated regime when it comes to cannabis. As we have said on many occasions, the reason we wanted to do that was to protect our youth but also to displace the black market.

I have received some queries from you and other members of Parliament who have received some concerns from people in their constituencies with respect to these types of matters.

One thing that we have to be clear on, however, is that the courts have been clear that people who need cannabis for a medical purpose need to have reasonable access to cannabis. Some individuals have received some injunctions in the past, and also we passed the new Cannabis Act last year.

As such, the minister has received new powers that didn't exist before the new Cannabis Act. Among those new powers that have been put in place, if someone has an authorization, not a prescription but an authorization, and it seems that the amount is really astronomical and just not reasonable, the minister can now decline that authorization. In the past, that wasn't the case.

As well, with respect to Health Canada inspectors, they are able to go into these facilities and conduct checks to make sure that people aren't growing too much cannabis and that they're following the authorizations. If under the authorization they're doing the growing within their home, Health Canada can't enter the home without a warrant. It's the police who need to do that. However, if people have it in a warehouse or in a field, let's say, they certainly can go and do the inspections.

Finally, the other thing is that you mentioned the phone number. If police authorities have any suspicions that anyone is growing illegally, growing too much, they can absolutely call Health Canada, 24 hours a day, seven days a week, because we have put a number in place. They are able to contact us, and from there, we will be able to advise them of the information they're seeking.

With respect to that—

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Health Canada has been saying, though, when the police have called the 1-800 number, that it's actually for the municipality to follow up.

That's not correct, because it's a Health Canada regulation.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

If there's a criminal matter under way, if someone is growing cannabis illegally, it still falls under the purview of the RCMP, or the—

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

Right, but if it's odour or too many plants, that's Health Canada's purview.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Then, from there, that's Health Canada's purview, absolutely.

[Marilyn Gladu, Conservative, Sarnia—Lambton, ON]

All right.

My second question is about Lyme disease.

Elizabeth May brought forward a private member's bill to put a framework in place on Lyme disease, which was published but contained not even the best practice testing protocol or the treatment protocol. Really, nothing has been done, and many Canadians suffering with Lyme disease are being forced to get test kits from the U.S. where they're commercially available and have treatments outside the country that cost thousands of dollars.

We know that if you think you have been bitten by a tick and may have Lyme disease, and if under the age of eight you have amoxicillin treatment, and over the age of eight you have doxycycline, you would never have any of the serious symptoms that Lyme disease patients are experiencing.

What will you do to address having the test protocol and the treatment protocol included in the framework?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Once again, Lyme disease is certainly a growing public health concern, specifically when we're looking at climate change. We know that climate change impacts the issue of Lyme disease as well. I come from the province of New Brunswick, and in the province of New Brunswick there is a real issue with Lyme disease. We certainly know it's a hotbed, if you will.

With respect to the investments we've made in this area, we've invested $20 million for health-related climate change programs, and most of that fund, I have to say, has been directed to Lyme disease.

With the funding with respect to it, we're focusing on diagnosis and treatment. Also, we're in the process of putting together a new pan-Canadian Lyme disease research network, which will be focusing on treatment and diagnosis.

I will pass the floor to my chief public health officer so that she can talk specifically about the treatment you're making reference to.

Dr. Tam, perhaps—

[The Chair, Liberal, Bill Casey]

We're over time, so let us have just a quick answer, if that's possible.

[Dr. Theresa Tam, Chief Public Health Officer, Public Health Agency of Canada]

I think the treatment guidelines are provided by the infectious disease expertise in the country, so they are not actually part of what the agency does. The research network the minister has spoken about has devoted its attention to looking at diagnosis and treatment.

On the diagnostic side we are constantly re-evaluating any new methods, but we will only include validated testing methods for the protocol that is going to be used in the provincial and territorial laboratories. I would certainly look towards the research network to enhance and build in any new evidence as we move along.

[The Chair, Liberal, Bill Casey]

Thanks very much.

Now we're going to go to Mr. Davies.

Just before we do, I want to support Mr. Webber's request to have that bill go through, because it is a lifesaver. We would all like to see it go through.

Mr. Davies, you have seven minutes.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you, Mr. Chair.

Thank you, Minister, for being here and for your graciousness in forgoing your statement so that we could have a chance to ask you questions.

Minister, of course there are many complex causes of the opioid crisis, but one significant aspect has been largely untouched by the federal government thus far, and that's the role that opioid manufacturers may have played in marketing these products in Canada. There is growing suspicion that drug manufacturers promoted a proliferation of prescription opioid use in Canada over the last two decades through an effort to minimize or conceal the risks of their products.

That conclusion has been proved in American courts. In fact, the U.S. federal justice department has secured criminal convictions, and they have recovered, along with states, almost $1 billion in fines and other costs as a result of violations of the food and drug act.

Last summer the NDP government in B.C. filed a civil lawsuit against drug companies to recoup the enormous costs incurred by that province in addressing the crisis. This week, of course, the Government of Ontario joined that proposed class action.

Minister, here is a simple question. Is your government planning to join that class action against opioid manufacturers?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Thank you so much for the question, Mr. Davies.

I have to say we're following very closely the two lawsuits that have been filed by British Columbia and also, this week, Ontario. Our legal officials are reviewing those two matters, and a decision will be made to see what exactly the federal government is going to be doing.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thank you.

Minister, I went back and read the mandate letter that Prime Minister Trudeau gave to your predecessor, Minister Philpott, back in 2015. That mandate letter instructed her—and you, when you got yours—to make prescription drugs more affordable for Canadians. According to the Canadian Institute for Health Information, however, prescription drug costs have grown for Canadians every year of your government's mandate, through the end of 2018, anyway.

Why has your government been unsuccessful so far in fulfilling that mandate and actually lowering the real costs of prescription drugs for Canadians?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I think we all recognize that the price of drugs is a complex matter, and we are working hard to make sure we do all that we can to lower the price of drugs.

If we want to move forward with the national pharmacare program, we have to get it right and we have to lower drug prices. That's why we're still in the process of modernizing the Patented Medicine Prices Review Board. That work is well under way, and there will be some announcements to be made.

The other thing as well is that I don't completely agree that we weren't able to lower the price of drugs, because by joining the pan-Canadian Pharmaceutical Alliance, we have actually saved more than $2 billion per year with respect to lowering the price of drugs. As we move forward with a national pharmacare program, the Canadian drug agency as well will have a significant role to play.

At this point in time, HESA members know more than I all of the intricacies of pharmacare, because you have done a study. When you realize that we have over 100,000 private drug plans in this country and many more through government, you'll see that it's very hard to negotiate drug prices. If we can put this together, get it right and get a national pharmacare program, I think there's going to be a cost saving for everyone here.

[Don Davies, NDP, Vancouver Kingsway, BC]

Absolutely. That's one of the reasons the NDP supports public pharmacare is to replace those with one MS plan per province would be enormously efficient.

You anticipated my next question on the Patented Medicine Prices Review Board. It's puzzling to me, Minister, because for almost three years your government promised to overhaul the Patented Medicine Prices Review Board to lower our drug prices. The finance department estimated that those reforms would lower drug prices for Canadians by $12.6 billion over 10 years. Then your government announced that those changes would be put in place at the end of 2018, yet they have not to this day.

We're in 2019, almost June. We still don't have them. Why has your government been so slow to implement changes to the PMPRB that everybody knows would immediately start saving billions of dollars in lower costs for Canadians? I'm curious as to why you haven't implemented them when they're so obviously there.

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Once again, this is work that is well under way and, as I have indicated earlier, there are going to be some announcements that are going to be made with respect to the modernization of the PMPRB. Since I've been Minister of Health this is a file that we've been actively engaged in. When it comes to, again, the implementation of a national pharmacare program, it's more than just putting a program in place. The priority is lowering the price of drugs and we certainly want to get that right.

[Don Davies, NDP, Vancouver Kingsway, BC]

With respect, this isn't pharmacare. These are changes to the PMPRB that you could do right now, whether there is pharmacare or not. There's something like taking the five comparator countries that we used, including the U.S. and Switzerland, the two highest prices in the world. Everybody in Canada who looks at the subject knows that you have to get rid of those five and put a comparison of 12 countries that are more representative, Germany, France, etc.

You could do that tomorrow. Why wouldn't you do that and immediately start lowering the cost of pharmaceuticals today?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

Once again, I've indicated there's going to be an announcement in the very near future. Stay tuned.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks.

Another thing that's puzzling to me is that your government just signed a new NAFTA, if I can call it that. I wrote a question to the Parliamentary Budget Officer and asked how much the extended protection for biologic data protection that the Canadian government conceded to the U.S. would cost. His estimate is $169 million per year.

If you want to lower the price of drug costs for Canadians, why would your government sign a trade deal with the U.S. that's going to cost Canadians billions of dollars in extra costs over the next decades? Why would you do that?

[Ginette Petitpas Taylor, Liberal, Moncton—Riverview—Dieppe, NB]

I can't respond with respect to the negotiations that take place, but what I can tell you as Canada's health minister is my priority has really been to do all that I can to lower the price of drugs. That's why we have been actively engaged with respect to joining the pan-Canadian Pharmaceutical Alliance where we have been able to lower prices and save money.

The other thing, which I've indicated as well, is we are in the process of modernizing the Patented Medicine Prices Review Board and all of that is saving us a substantial amount of money.

Perhaps if my deputy minister wants to comment any further, I'll punt it to him.

[Don Davies, NDP, Vancouver Kingsway, BC]

I'd like to get one more question in, Minister.

Pharmacare advocates were recently quite alarmed to see you deliver the keynote speech at a Canada 2020 forum on May 14 that was dominated by lobby groups that oppose universal public drug coverage. Doctors who support that coverage called it a one-sided event. Former Liberal health minister Jane Philpott reacted to your speech saying that the one-sided event is problematic and makes her nervous about the government's commitment to pharmacare. It was sponsored by the Canadian Life and Health Insurance Association and Innovative Medicines Canada, which represents Canada's pharmaceutical industry.

Minister, do you agree that your participation in that event was problematic? How do you respond to pharmacare advocates who argue that corporate lobbyists appear to have too much influence on your government's pharmacare deliberations?