Health Committee on Sept. 22nd, 2016

[The Chair, Liberal, Bill Casey]

Can you put that in writing for us so that everybody can see it?

[Len Webber, Conservative, Calgary Confederation, AB]

It has been tabled, and I understand that you're going to make a ruling on it, a vote, on whether or not this motion is going to pass. I'm introducing an amendment to that motion.

[The Chair, Liberal, Bill Casey]

We have your original amendment. I'm not trying to give you a hard time; we just need to know exactly what we're voting on.

[Len Webber, Conservative, Calgary Confederation, AB]

The committee would undertake an “immediate study” rather than “an emergency study”.

[The Chair, Liberal, Bill Casey]

It's just to change “immediate study” to “emergency study”.

[Len Webber, Conservative, Calgary Confederation, AB]

That would be one item.

[The Chair, Liberal, Bill Casey]

Actually, it would be changing “emergency” to “immediate”.

[Len Webber, Conservative, Calgary Confederation, AB]

That's right, yes.

I guess then insert “fentanyl and opioid crisis in Canada, in light of the alarming and growing number of deaths caused by these substances to determine what action can be taken by the federal government.”

It's more specific. It has an action plan. It hopefully requires it to be an immediate study because of the urgency.

[The Chair, Liberal, Bill Casey]

Mr. Davies.

[Don Davies, NDP, Vancouver Kingsway, BC]

I think Mr. Webber's amendments amount to a difference without a distinction. Changing my word “emergency” to “immediate” is of no consequence whatsoever. In fact, I would argue that “emergency” probably has more impact than “immediate”.

Second, as to adding fentanyl, fentanyl is an opioid, so when you say “opioid crisis”, that includes fentanyl. When he adds the words “in light of the crisis in Canada”, that's already understood. It's just an elaboration on the opioid crisis.

Finally, to determine what action would be taken, my motion is to undertake an emergency study of the opioid crisis in Canada. I believe it is obvious, clear, implicit and understood from the motion itself to be a study to determine what action should be taken. That's understood.

I don't think any of the amendments add anything to the motion as it stands. With great respect, it appears to me that pride of authorship is trying to take priority over getting to the actual substance of it, which is to get this committee to recognize the opioid crisis and to start studying it as soon as possible.

The reason that I don't think “immediate” is appropriate is that “immediate” suggests a certain time for action. An immediate study would mean we start studying right now. Do we suspend the pharmacare study right this moment and get at it? I didn't think that was fair to the committee. Although we, on all sides of this table, recognize the importance of this issue, we also recognize that we'll have to do a little bit of planning. We have to get witnesses before this committee that will be able to give us good advice on opioids. That's going to take a little bit of time, so I don't think we can start this study immediately. My motion recognizes that it's an emergency. It gives us the flexibility to take the next three or four days to suggest witnesses and to allow the analysts to plan the meetings. We have witnesses lined up for pharmacare for next Monday and Wednesday.

I think my motion does everything Mr. Webber wants it to do. If we're really interested in this, let's get at it, vote on the motion, pass it, and then we can get at the pharmacare study.

[The Chair, Liberal, Bill Casey]

Dr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

I would concur with Mr. Davies. I understand your intent, Mr. Webber. However, if we say “immediate”, we might find ourselves obligated by the meaning of the word “immediate” to suspend all other business. That would mean sending home all the witnesses that we'll be having for the next three meetings, which I don't think we can do. Also, the amended motion has specifics we don't need. Fentanyl is only one of the opioids that we're dealing with in a crisis. There are several opioids.

Again, I understand the intent of your amendment, but I don't think there's any advantage to it. I think Mr. Davies's motion says it all. It gives us the flexibility to continue with the next three meetings we have on pharmacare, and then get going on this. If there's a motion on the floor, I'll second it.

[The Chair, Liberal, Bill Casey]

Ms. Harder.

[Rachael Thomas, Conservative, Lethbridge, AB]

In 2014 this committee conducted a study on opioids in Canada. The interesting thing about what we face today is that we're not just looking at opioids in general. Rather, we are looking at the distinct nature of fentanyl, and that is where the emergency takes place in 2016. In order to draw a distinct line between the 2014 study which was already conducted and what we might spend our time wisely doing now, I think fentanyl is a key point in this study.

[The Chair, Liberal, Bill Casey]

Dr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

I hate to split hairs on this. I agree that fentanyl is part of it, but there are also some novel opioids that have just come on the scene in the last month that are different from fentanyl and even more dangerous. I agree with you that fentanyl is part of it, but there are others as well that are even newer that are part of the same crisis.

Again, I don't see the advantages of specifying fentanyl. Carfentanil is one that's come up. It's a different compound. I read about it years ago and I didn't think we'd ever see it on the streets.

I don't think we need that distinction. It's all opioids, it's all a crisis, and I think what we have covers it in the generality. People are still dying of the older opioids. There's still the old OxyContin out there, and there's still heroin. It's part and parcel of the same problem, and I think this motion gives us the flexibility to study that.

[The Chair, Liberal, Bill Casey]

It's coincidental that there was a news program last night about this very subject, about how to raise the profile of it, and how important it is.

Mr. Webber.

[Len Webber, Conservative, Calgary Confederation, AB]

Mr. Chair and committee, this is an emergency. This is something that has to be done immediately. I respect your comments, honourable member, but we have to get this done now. If it means our having to postpone a few presentations on pharmacare, then I would say so be it. We heard the panel the other day, and the crisis situation that we're in with this fentanyl issue, and I believe we have to do an immediate study. Of course it is an emergency, but what does that mean? Immediate study indicates the fact that it has to get done right away.

With respect to the other wording, we need to give it some teeth. We need to have an action plan and a purpose. I think this action plan could be an immediate report that can be written up once we have this study undertaken. I can't stress enough the emergency that we're going through right now. The requirement of an immediate study is that it has to be done now.

[The Chair, Liberal, Bill Casey]

Just by the sound of things, and looking at the schedule going forward, if this passed, then we would probably be starting it a week from Tuesday. I think that's pretty quick. We have to have a work plan, and we also have to have witnesses. If we had two more meetings on pharmacare, which are already scheduled and with the witnesses already scheduled, if it passes, that would allow us the time to get witnesses, and the proper ones whom we all want to hear from. It would allow us to ensure that the witnesses on the other meeting finish, and it would give the researchers a chance to give us some information on it.

Ms. Harder, you're next.

We're talking about a week from Tuesday, if it passes.

[Rachael Thomas, Conservative, Lethbridge, AB]

I understand what's being said with regard to splitting hairs, and I'm certainly not wanting to belabour this point. With everything that's taking place in the news, and the fact that this is drawing such careful attention, or prominent attention, in Canada right now, I think a focus on fentanyl deserves our attention, given the national scope of this issue.

We heard the witnesses the other day, and their focus was on fentanyl. With all due respect, it wasn't on other opioids; it was largely on fentanyl. It is what's making it into the news day in and day out across this country. It is what is causing us concern in provinces like B.C. where we're seeing alarming death rates. I think it deserves careful study.

[The Chair, Liberal, Bill Casey]

Mr. Kang.

[Darshan Singh Kang, Liberal, Calgary Skyview, AB]

Mr. Webber, we perfectly understand your concern. Everybody is passionate to get something done about this. If you're suggesting fentanyl is the issue, maybe we could say, “study of the opioids, such as fentanyl, crisis in Canada”. That's just a suggestion. If we put “fentanyl” in the motion, would that satisfy you?

[Len Webber, Conservative, Calgary Confederation, AB]

Thank you, Mr. Kang. I don't want to—

[The Chair, Liberal, Bill Casey]

No, we need Dr. Eyolfson.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

At this point if there's a motion on the floor, I'd like to call the question.