Health Committee on Nov. 29th, 2016

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Mr. Chair.

I want to thank the witnesses for being here for this very important meeting. Before I start with my questions, though, I do want to ask for unanimous consent, Mr. Chair, for this motion that I have. As we're looking at the opioid crisis and we really did a lot of work on that interim report, I'd like to ask for unanimous consent for a motion that I think is extremely timely.

I move that pursuant to Standing Order 108(2), the committee call upon the Minister of Health to immediately appear as a witness to discuss the opioid summit and the next steps in dealing with this serious crisis.

I didn't put forth this motion before as we were dealing with that Alzheimer's bill, but I must first thank the committee members for working together on a report on this extremely serious crisis, the challenge being a timely one. I believe in the last 24 hours seven or eight Canadians have died of opioid overdose. Since the minister has just completed her summit, I think it would be a very timely opportunity now to get her to come here and give her testimony so we can actually add her very important testimony to our report. This is something that I think is not going to be going away. It is a crisis. Everybody recognizes it as that.

I want to thank the committee members who went on the unofficial tour of that clinic. It really hit me to talk to someone who is addicted to these opioids and to know that there is hope and help out there. I think the minister has great insight on that, since the summit has just been completed. Before we let this go too far, it would be great if we could have her come as soon as possible to committee so that we can complete our very important report.

Therefore, I'm asking for unanimous consent. I think it's pretty obvious.

[The Chair, Liberal, Bill Casey]

Go ahead, Mr. Ayoub.

[Ramez Ayoub, Liberal, Thérèse-De Blainville, QC]

Thank you, Mr. Chair.

With all due respect to my colleague and especially to the witnesses, and despite the important issue he is raising, I want to point out that we have spent a lot of time studying the opioid crisis. It does not seem appropriate to discuss it now and to ask for unanimous consent for a motion, while we have witnesses who are waiting for questions.

I strongly suggest that we get back to this later, specifically, so that we can really take the time we need to discuss the issue. I am feeling somewhat stymied as to how to continue our discussions. This seems like an important aspect that requires our study. However, I have a great deal of respect for the people who came here. I have questions for them and certain other colleagues surely have some as well. As we know, our time is limited and goes by quickly.

[The Chair, Liberal, Bill Casey]

Go ahead, Mr. Oliver.

[John Oliver, Liberal, Oakville, ON]

I move that we suspend debate on this topic.

[The Chair, Liberal, Bill Casey]

We have to have a vote on the motion to suspend debate. There's no debate on that motion. The motion to suspend debate is votable right now, and there's no discussion.

(Motion agreed to)

We're suspending that motion. I'm not saying it's going to go away, but right now it's—

[Colin Carrie, Conservative, Oshawa, ON]

It's extremely important, and I thought we could get unanimous consent quite quickly.

[The Chair, Liberal, Bill Casey]

I don't know how that will go, but I thought certainly the visit that we had to Dr. Ujjainwalla's facility was impressive.

We're going to resume your questioning.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much.

My first question is to Doug. You brought up an extremely challenging ethical question.

[Don Davies, NDP, Vancouver Kingsway, BC]

Mr. Chairman, I have a point of order.

I'm sorry. With great respect to Dr. Carrie, are you counting the time that was used in that point of order in terms of his questioning?

[The Chair, Liberal, Bill Casey]

Yes, that's his time.

[Don Davies, NDP, Vancouver Kingsway, BC]

Thanks.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much.

You brought up an extremely important challenge and ethical dilemma when you're looking at a pan-Canadian pharmaceutical-type program. You mentioned value for money. Of course, you brought up Soliris, the big one in the room.

My question to you would be this. If Canada implements this type of program, however it lands, who would decide on which drugs are covered? It's an extremely difficult question, because if you're one of the patients who would really benefit from a drug that's out there and you'd really want to have access to that drug but you have a system that won't allow you access, how would you suggest to this committee that a program could get around that problem?

[Dr. Doug Coyle]

We do the same for technologies right across the health care system. We decide what's covered and what's not.

I have a chronic hip problem. My physiotherapy is not covered under the Ontario Health Insurance Plan. We've decided that's not something that is beneficial to cover. The only reason that we seem sensitive to pharmaceuticals is there's a pharmaceutical industry lobbying for the coverage of their products.

We need to make consistent decision-making. That is the job of decision-makers. If a product is not worthwhile—don't think about it in terms of dollars and cents, but think about it as funding this technology—you are denying someone else a health care intervention that will provide more benefit to them. If you cannot make those decisions as a decision-maker, you need to get a new job.

[Colin Carrie, Conservative, Oshawa, ON]

You brought up an example of physiotherapy. I don't think anybody around the room here would argue that physiotherapy is not a very scientifically evaluated form of therapy, but we've had decision-makers say that it's not covered in Ontario. I myself am a chiropractor, and chiropractors face the same issue.

Canadians have the option as well of buying private health insurance, so you may have private health insurance that would cover physiotherapy, chiropractic, vision, or audiology, these things that historically have not been covered, but for pharmaceuticals, some witnesses have suggested that we don't have that private insurance system. We just have one monopoly type of thing. If we do put something forward, would your recommendation be that Canadians should maintain the option of getting a private type of insurance?

[Dr. Doug Coyle]

I think that's not really part of the issue here today. I think the issue here today is how we are going to make decisions at a national level over what is covered through the publicly funded health care system. The decision about whether or not people have access to other health care through a private insurance is a separate decision.

We have to remember that the Canadian health care system is really a historical accident. We have coverage for physicians in hospitals mainly emanating from early decisions made in Saskatchewan about trying to ensure they have adequate availability of physicians. We have a health care system that has arrived just through accident, based on those events in the early 1920s.

To be honest, if you want to make a system that is sustainable, that is beneficial to all Canadians, we have to consider all health care interventions that are on the table as potential, valuable interventions to fund, and we should stop advocating just for those for which there's a commercial sponsor who's willing to make a profit from them.

[Colin Carrie, Conservative, Oshawa, ON]

I'm sorry; I may have misspoken. My question is whether Canadians should be allowed to buy private insurance for pharmaceuticals too, with the proper—

[Dr. Doug Coyle]

I think I answered that question.

[The Chair, Liberal, Bill Casey]

That's it. Your time is up. Thanks very much.

We have Mr. Davies for seven minutes.

[Len Webber, Conservative, Calgary Confederation, AB]

Excuse me. On a point of order, Mr. Chair, with regard to Dr. Carrie's time, it was brought up that you were going to take away some of his time for his motion. Does that include also the response that came from our Liberal counterparts? Is that included in his time allotment?

[The Chair, Liberal, Bill Casey]

That's a good question. It's all included in Dr. Carrie's time on that issue, and I gave him—

[Len Webber, Conservative, Calgary Confederation, AB]

I find it rather unfair, to tell you the truth, that they went on, likely knowing that they were using up his time. I don't know, but I think he should have more time to ask his questions, as a lot of the time was taken up by—

[The Chair, Liberal, Bill Casey]

We're just following the rules, and we're taking up time now. I appreciate the point, but we're following the rules.

[Len Webber, Conservative, Calgary Confederation, AB]

We're taking up time from whom right now, Mr. Chair?

[The Chair, Liberal, Bill Casey]

Actually, it's stopped.