Health Committee on Dec. 13th, 2016

[The Chair, Liberal, Bill Casey]

I call our meeting to order.

We'll continue our briefing on the opioid summit that just took place.

We're certainly pleased to have the Honourable Jane Philpott, the Minister of Health, with us today. I understand she's here for an hour, and then she has some other duties she has to perform, so we should get right into it.

Also from the Department of Health, we have Simon Kennedy, deputy minister, and Hilary Geller, assistant deputy minister. From the Public Health Agency, we have Dr. Gregory Taylor, chief public health officer, back for another little visit.

I want to thank you all for coming. Would you like to make a statement or would you like to go right to questions?

[Jane Philpott, Liberal, Minister of Health]

I would be happy to make a statement.

Thank you, Mr. Chair, and members of the committee, for the opportunity to come and be with you today to speak to the opioid crisis, which I gather was one of the reasons you wanted me to appear before you today.

Thank you, Chair, for introducing my colleagues from Health Canada and the Public Health Agency of Canada.

I have a few opening remarks, and then, of course, I look forward to your questions.

Before I start, I want to thank this committee for the fantastic work you've been doing on a whole number of fronts and to let you know how much I appreciate the work being done here and how much I look forward to further studies coming out of this committee. In particular, I want to thank you for your study and report related to the opioid crisis.

As you know, this is a serious matter facing our country. Of course, we have differing views on certain strategies, but we know that overall this is an issue that needs to be addressed from a public health perspective. It's not an issue in which partisanship needs to interfere. We need to focus on saving the lives of Canadians.

I think this committee is well aware of the statistics and the fact that hundreds of Canadians have died already this year. If you look at British Columbia alone, up to the end of October there were over 600 deaths related to opioid overdoses. I'm sure that the committee also heard a great deal about addiction as you were doing your study. You heard people talk about the fact that addiction can happen to anyone, that it's a chronic illness, that it affects people of all ages and of all socio-economic groups, and that it impacts communities all across this country.

These matters are urgent. The number of deaths related to opioids has complex roots. It's dimensional, and it requires swift action on behalf of all of us in this vocation.

I have been addressing this matter since the very beginning of my responsibilities as Minister of Health, and I have been making decisions in an attempt to promote health and to save lives. I believe we need to continue to have a health-focused approach to the opioid crisis.

Some of you know that last month I was in British Columbia and visited front-line workers. I was at Fire Hall 2 in downtown Vancouver and met with paramedics and police officers and firefighters as well as many health care providers. Hearing from them about what this means on the ground and the challenges they face every day in trying to save the lives of victims was very moving for me.

Later that month I, along with the Ontario Minister of Health, Mr. Hoskins, hosted a large gathering that some of you were able to attend. It was a conference and then a summit, where we had representatives of government, health care professionals, and community members talking together about how we need to respond.

We have taken many government actions to date on this, including, of course, the work of this committee. We have continued to focus on a public health approach. You have no doubt heard of some of the announcements yesterday, which I'll refer to shortly, but first of all I wanted to make sure you were aware of a number of steps that have been taken so far.

One of the early steps we took was to make sure that naloxone was available in a non-prescription status. We also heard about the need for a naloxone nasal spray, and we were able to expedite an emergency importation mechanism to get nasal spray into the country. We were later able to expedite an approval of naloxone nasal spray for production in Canada.

We realized that one of the things we needed to do was to focus on harm reduction. In that light, early on I approved an exemption for the Dr. Peter AIDS Centre to operate a supervised consumption site in Vancouver. We were also able to give an unprecedented four-year renewal to Insite, which is an extraordinary site based in downtown Vancouver.

We also were asked to reverse the federal prohibition on the use of diacetylmorphine, which is pharmaceutical heroin. It is proven as a medication for the treatment of addiction, and it is now available under a special access program.

Last week we took steps to schedule fentanyl precursors, making it harder to access some of the chemicals used to make illicit fentanyl. Yesterday we introduced amendments to the Controlled Drugs and Substances Act and other acts.

It's important to recognize the big picture of why we did that. It is fundamentally taking a health-based approach to problematic substance use, and the new Canadian drugs and substances strategy replaces the former national anti-drug strategy.

It formalizes the government's approach to drug policy, which is comprehensive, collaborative, compassionate, and evidence-based. The lead for the strategy has now returned to the Minister of Health, and we have reinstated harm reduction as one of the four pillars of drug policy, along with the pillars of prevention, treatment, and law enforcement.

You can ask me more details later, but I wanted to give you a bit of an overview of what's included in some of the details of that bill. One of the things we did was to streamline the approach for communities that feel there is a need to have a supervised consumption site in the community. In order to do that, we removed the 26 criteria that had been in place in the previous legislation, and we replaced those with a requirement for the Minister of Health to demonstrate evidence of public health and public safety benefits.

This comes in part from the 2011 Supreme Court decision, which stated that where the evidence indicates that a supervised injection site will decrease the risk of death and disease and there's little or no evidence that it will have a negative impact on public safety, the minister has a responsibility generally to grant an exemption.

The Supreme Court also gave us guidance on what kinds of things the Minister of Health should take into consideration in making that decision, and there were five factors in particular that were emphasized.

The first is that there has to be a demonstration of community need. Second, there has to be a demonstration of community consultation and support. Third, the minister has to have an understanding of the potential impact on crime rates. Fourth, there need to be regulatory systems in place, and fifth, there needs to be evidence that the site has the appropriate resources in place.

Given all this, we know that there is an abundance of evidence that well-established and well-maintained supervised consumption sites in communities that want and need them will save lives, prevent infection, and introduce people into the health care system in a way that will not increase crime rates and will not increase problematic drug use.

There are a number of other elements in the bill that you may want to ask about. You have probably heard that we will be prohibiting unregistered importation of pill presses and encapsulators to help to address the matter of the illicit supply, production, and distribution of drugs.

We will be removing the exception in the Customs Act that currently prevents border officers from inspecting mail that's 30 grams or less. This will allow us to stop the importation of dangerous substances such as fentanyl, which are often shipped in these very small packets.

There are a number of other amendments to the Controlled Drugs and Substances Act. They're there to help increase the flexibility that we have to address emerging risks. They allow us, for instance, to temporarily add a substance that we believe poses significant risk to public health to a temporary schedule on the Controlled Drugs and Substances Act pending a comprehensive review and a decision on permanent scheduling.

All in all, the response to the opioid crisis requires a comprehensive approach. It requires actions like those we took yesterday to essentially stop people from drowning, as it were, but we also have to take steps to address root causes, the reasons people fall into the water in the first place, if we are to use that water metaphor.

The Canadian Mental Health Association talks about the opioid crisis having multiple roots. Some of those roots are in the health care system. Canada is the second-highest per capita consumer of opioids, and we took steps during the summit to address the roots of the crisis with the role of prescription drugs. We brought together at that meeting seven provincial and territorial health ministers and a broad range of stakeholders, and we developed a very interesting and impressive list of actions that these 42 organizations are committed to taking in a joint statement of action. There's also a commitment on our part to report on the progress quarterly.

I thank you for being here today. Thank you for working alongside us to be able to address this very serious matter that affects some of the most vulnerable Canadians. We need swift action on this. We need a renewed focus on a public health approach that includes harm reduction and addresses root causes. We absolutely have to work collaboratively to save the lives of Canadians and promote their health.

Thank you very much.

[The Chair, Liberal, Bill Casey]

Thank you very much.

You are right on target at 10 minutes.

We're going to go to questions now. We'll go to our first round of seven minutes, and we're going to start with Mr. Ayoub.

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

Thank you, Mr. Chair.

Madam Minister, thank you for being here and for your valuable input on our work, especially as regards the opioid crisis that you have brought to the fore. Yesterday's announcement is very positive and forward looking.

I have a few questions. I will focus on the facts.

The number of criteria for opening supervised injection sites has been reduced to five. There are only two such sites in Canada right now.

How many sites do you expect will be opened in Canada and in what timeframe? Is there a specific objective in this regard or are you waiting to have discussions with the provinces and the communities affected? If there is such an objective, how will it be reached?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Thank you very much for the question. You actually raised a whole series of questions within that one, and I'll try to speak to each of them if I can.

I encourage members to read the Supreme Court decision of 2011, if you haven't already. It was informative for us in coming up with this legislation yesterday and it lays out the criteria as to when and if these kinds of sites should be approved. I think you'll see that it's quite helpful.

You spoke to the matter of the number of sites that there are now, and you're absolutely right: so far there are two that have received an exemption, the Dr. Peter Centre AIDS Foundation and Insite, both of them in Vancouver. A number of applications are in place. I believe there are three from Montreal, if I'm not mistaken—no, four now from Montreal, two from Vancouver, and three from Toronto. Is that it?

[A voice]

Yes.

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Okay. Those are the ones for which we have received the full and entire applications. Several other communities have applications that are in process, and my department has been helping them with some of the steps along the way.

One of the challenges under the current legislation was that we were not able to comment or to even provide feedback or begin a review of an application until it was complete. That requires, in some cases, as in some of the new applications in Vancouver, that they have an almost complete application. They have some work to do on, for example, renovating the space where they want the site to be available, but we can't actually do all of the work until things are complete.

Our commitment now is to have a much different approach, in a number of ways. One is that we intend to be able to post online the progress that sites are making so they can see where they are and which pieces are missing. The federal government actually takes the heat on not approving these sites, when many times the barriers to site approval have nothing to do with federal jurisdiction but have to do with local municipalities or with provincial governments providing support, for example. We want to be more clear on that, so that advocates who are pushing for this are pushing on the right levers to be able to get these sites open. Once this legislation passes through, we're also committed to allowing partial reviews of applications that are in process.

Hilary may have some other things to add, but I want to also address the last question, which I think is really important in terms of where we foresee these going and how many communities will have them. I think it's very important that this committee have a central role in this so as not to cause undue anxiety in communities where it's absolutely not appropriate to have supervised consumption sites. This is a crisis that is spotty in where it affects people. Yes, there are people across the country who die of overdoses, but there are some areas where the crisis is intense, as in southern British Columbia.

In those communities that want and need them and where there's strong community support, we have to be able to make them available to save people's lives, but there are all kinds of communities in the country where it's not appropriate, there's no community desire to have one, and there's no demonstrated need. Clearly the fearmongering around supervised consumption sites on every street corner is not helpful at all. We need to make sure that these will go to the communities that need them, that are crying out for them because people are dying, and we need to support those places.

Do any of you want to fill in any blanks? No? Okay.

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

Thank you for your answer. It is very clear.

The number of approval criteria for new sites has been reduced to five. You want approval to be simpler and faster, perhaps for locations where the need is the greatest, as you stated. Some people support this while others are opposed. It is never really 100% clear.

As to one particular criterion, some police services have made certain recommendations. Moreover, you mentioned the decision that clearly shows that crime rates fall when these sites are created, not to mention reducing the number of sudden deaths of people with this problem.

What will you do to influence, educate or inform the police services that appear to be more reluctant? The Ottawa Police Service, for example, already expressed doubts this morning about the approach, whereas, in other parts of the country, people are very open and are anxiously waiting for sites to be approved.

What does Health Canada intend to do to help these municipalities, these cities? Is there a specific approach?

[Jane Philpott, Liberal, Markham—Stouffville, ON]

Those are excellent questions, and it gives me an opportunity to clarify that there will still be an application process involved that speaks to how the minister will get information to be able to make sure that those five factors have been appropriately considered. There will be guidance within the application process to show things like whether an impact on crime could be demonstrated. Some of it could be by, for example, having correspondence related to the chief of police in that particular area. There will be ways that we will support communities to be able to demonstrate that they have met the specific factors given by the Supreme Court.

The point that you raise is a very interesting one in terms of sometimes hesitation on behalf of law enforcement as to whether or not this is a helpful mechanism. I would encourage members, if you ever possibly can and you're in Vancouver, to go visit some of these long-standing supervised consumption sites like Insite. It has been established since 2003. You cannot help but be moved by this place, where people are greeted at the door in a non-judgmental way, where they make every effort to reduce the stigma associated with problematic substance use, and where people are welcomed and given an opportunity to be introduced to the health care system at the point that they are ready.

Anyway, I could go on and on about how impressed I was by the work of Insite and how I really see it as being a helpful resource in that community.

The interesting thing that happened in Vancouver is that there was.... You're right, there was not 100% community support at the time that it was originally approved, but all evidence says that many, many people who were initially skeptical about whether or not this would be helpful in terms of decreasing crime rates or decreasing, for instance, the number of dirty needles that were in local parks, etc., have come around. The community support and the support from law enforcement, in particular the Vancouver police, is absolutely stunning. People are convinced that this has been an effective mechanism, and there have been zero deaths despite the fact that there are literally hundreds of people who use these services every day. I would certainly encourage law enforcement officials in other communities who are skeptical to go and see what an effective site can look like.

[The Chair, Liberal, Bill Casey]

Thank you very much. Your time is up.

Welcome to our committee, Mr. Brown. You have the floor.

[Gord Brown, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Thank you very much, Mr. Chairman.

Thank you also to our officials and to the minister for coming today.

I think it's a positive development that they're here for the opioid study. It's a very terrible thing that's happening in our country.

Thank you to the government for making it a priority to address this. However, Minister, as you know, I've asked you three times in the House about thalidomide. We have a December 9 notice of motion by Rachael Harder—I'm subbing in for her today—and that motion is:

That, pursuant to Standing Order 108(2), the Committee immediately undertake a study on thalidomide that: (a) focuses on the forgotten survivors of thalidomide; and (b) examines the effectiveness of the 2015 Thalidomide Survivors Contribution Program.

Mr. Chairman, that motion is in order, and I'm now going to speak to it.

I'm happy to speak to this motion that is essentially asking the committee to examine the effectiveness of the thalidomide survivors program. From the evidence that I've seen, I believe that at the end of the study, the committee will be calling for fair treatment of, and compensation for, the forgotten thalidomide survivors who cannot produce paperwork or witnesses to prove that their mothers took thalidomide. I believe that with the study the committee will find that these people need to be given a personal interview by a qualified professional and then given whatever tests are required to prove that their physical disabilities are not caused by a genetic anomaly.

I'm aware that there is no test that can prove thalidomide use by their mothers. However, the physical evidence they all display, and genetic testing to prove that it isn't something else, can go a long way to drawing the conclusion that thalidomide is the cause of their disabilities.

I believe that as a result of the study, this committee will recommend that Crawford victim services, the company making the decisions about whether or not to compensate these survivors, try to include people in the compensation package, not exclude them—which I believe, from the evidence I have seen, is their current practice.

On several occasions in the House I have asked the Minister of Health to address this situation, and she has been asked the same question by the media. She continues to refuse to act compassionately for these survivors, so I'm asking this committee to use its independence to undertake a study to determine what can be done to help these folks.

On October 25 a number of the forgotten survivors were here in Ottawa as my guests to address the media about the unfairness of the current compensation process. I want to quote extensively from remarks that were given by Mr. Terry Bolton, who is here in the committee room today, but before I do that, I want to note that Mr. Bolton lives in my community of Gananoque, Ontario, and I have known him since we were both young children.

To see Mr. Bolton, if you know anything at all about thalidomide, you can clearly see that he is a victim, or survivor, of the drug. That is the first thought that crosses your mind when viewing his physical condition. He has phocomelia—from the Greek words phoke, meaning “seal”, and melos, meaning “limb”—in which the hands or feet, or both, start immediately from the main joint, like the flippers of a seal. This is the limb malformation most traditionally associated with thalidomide. He also has an extra thumb that was amputated at birth, another dead giveaway marker of thalidomide.

Allow me to tell his story in his own words.

He said:

In 2012, I found out that my Mom had taken “the morning sickness” drug: Thalidomide, while pregnant [with] me in 1962. I confirmed this with her two surviving sisters. Up until then I had been led to believe that I was a “gift” from God and made “special”.

I set about to educate myself on everything related to Thalidomide. Upon doing research I discovered that my deformities and internal organ problems were “side-effects” caused by Thalidomide.

I had numerous operations as a child. My intestines were bleeding from somewhere, but they never really determined where “exactly”, but proceeded to remove my appendix as well as my Meckel's diverticulum.

My internal ear organ on the left side is missing parts resulting in tone-deafness since birth. I'm now considered legally deaf in both ears.

I was also born with a left deformed arm and hand and with an extra thumb on my right hand. This was surgically removed at birth.

I was also born with very deformed toes on both feet, which resulted in surgery to remove a “double bone” in one of my toes.

I also had heart surgery to correct what is referred to as Wolff-Parkinson-White syndrome. Basically my heart has an extra valve that was causing it to do more work than needed.

This was believed to be a contributing factor in the 40% mortality rate of Thalidomide babies.

I got lucky and lived with my “murmur” for 49 years.

I tried diligently to obtain my birth records and medical records as requested by Crawford.

I remember my orthopedic Surgeon, Dr. John Hazlett telling me as a child of 8 or 9 that “We have enough x-rays of you to make 6 complete skeletons”.

Well according to my birth Hospital, all records and x-rays have been destroyed due to their “retention policy”.

I researched to find out there was a fire in their records building between 1975-79.

There were also two fires in my hometown of Gananoque that destroyed the Pharmacy that my parents used, as well as my Family Doctor's Office.

I believe [every one of the forgotten survivors] has, as well as the other survivors', similar stories to tell.

This now comes down to why we are here. We, Canada's Forgotten Thalidomide Survivors wish to be recognized and compensated for the tragic mistake the Canadian Government made in 1959 when they allowed Thalidomide into OUR country.

It's time to right a very big wrong.

That is the end of his remarks, and he said that on October 25.

Now, living in Gananoque, I can verify personally that the fires that he mentioned in his presentation occurred as he stated. I do remember both of those fires that happened when I was a teenager. I talked with each and every one of those victims who came here to Ottawa who were here on October 25, and their stories are truly heartbreaking. They have all suffered all of their lives because of their exposure to thalidomide, and now they are being denied even the decency of an in-person interview to see if they have the effects of thalidomide. They've all had extreme health issues, medical issues that continue to this day. These issues have required hospital stays and operations. Many suffered from abuse and cruelty from other kids.

Many, like Mr. Bolton, have taken as much training as possible, but have been unable to work or even find employment. One woman, featured on a recent W5 report about the forgotten survivors who have survived a lifetime of rejection, lives alone in the backwoods of British Columbia.

As I said, their stories are heartbreaking. The thing that really bothers me—

[The Chair, Liberal, Bill Casey]

Excuse me, Mr. Brown; your time is up. I have limited time on this motion. Are you moving the motion?

[Gord Brown, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

I move the motion, and I—

[The Chair, Liberal, Bill Casey]

Okay. I just wanted to clarify whether you were going to continue with your seven minutes on this motion.

[Gord Brown, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

This motion, Mr. Chair, is in order.

As I said, their stories are heartbreaking. The thing that really bothers me about this is that we are talking about a couple of dozen people.

[John Oliver, Liberal, Oakville, ON]

I have a point of order.

[The Chair, Liberal, Bill Casey]

Go ahead, Mr. Oliver.

[John Oliver, Liberal, Oakville, ON]

I want to thank the member for his very impassioned statement and the motion he is bringing forward, but we do have the Minister of Health here to discuss the opioid crisis. We stopped our other work to deal with this crisis, so I would move that we suspend further debate on this topic and return to our discussion of the opioid crisis.

[Gord Brown, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

Mr. Chairman, my motion is in order, and I am speaking. That's not a point of order.

[An hon. member]

He's right.

[Gord Brown, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

The thing that bothers me about this is that we are talking about a couple of dozen people. In the overall scheme of things, what financial impact will assisting them have on our country? Let's put into perspective the cost in order to make their lives a little bit easier for however long they have remaining. As I said in the House, it is a disgrace to think that we, as members of Parliament, in the greatest country in the world, can't collectively do something to assist a few of our fellow citizens who have suffered since birth as a result of a decision made by their country's federal health department.

Canada offered a compensation package in 1991. It included an in-person examination. Many people, such as Mr. Bolton, were either not aware of the 1991 package or, as in his case, their mothers never admitted to them that thalidomide was the problem. It was only after his mother passed away that he learned the truth from his aunts.

It is important to note that Canada is not alone in its compensation offerings. Countries such as Britain, Germany—where the drug originated—and Australia have also offered compensation packages to their victims. In Britain there was one offering, and then there was a second and greater offering after the victims realized that the first package wasn't enough to compensate them. Victims received the courtesy of an in-person examination.

For those who maybe don't understand thalidomide, let me use information from a website that was organized to provide such background to Canadians. This will explain the history and background to this issue.

Thalidomide was first marketed commercially in West Germany in 1954 by the drug company Chemie Grünenthal. There is some unproven evidence that it may have been developed during the Second World War by Nazi scientists. This stems from the fact that a known Nazi was hired by the drug company shortly before the release of thalidomide. It was available to patients in West Germany into the 1960s. Thalidomide was present in at least 46 countries under many different brand names. Thalidomide became available in simple tablet form in Canada in late 1959. It was given to many pregnant Canadian women to relieve morning sickness and to help them sleep.

Some of the forgotten survivors today were the result of the samples that were given to their mothers. This means that they could not come up with a prescription order even if the pharmacy records still existed. There is unconfirmed evidence that it may have been brought into Canada even earlier than this by doctors who had served in Korea and had come across the drug. It was licensed for prescription use in Canada on April 1, 1961. Although thalidomide was withdrawn from West Germany and the United Kingdom markets by December 2, 1961, it remained legally available in Canada until March 2, 1962, a full three months later. Incredibly, thalidomide was still available in some Canadian pharmacies until mid-May of 1962. Sample packs may have been given beyond this date.

Thalidomide was hailed as a wonder drug that provided a safe, sound sleep. Thalidomide was a sedative that was found to be effective when given to pregnant women to combat many of the symptoms associated with morning sickness. It was not realized that thalidomide molecules could cross the placental wall, affecting the fetus, until it was too late.

Thalidomide was a catastrophic drug with tragic side effects. Not only did a percentage of the population experience the effects of peripheral neuritis, a devastating and sometimes irreversible side effect, but thalidomide became notorious as the killer and disabler of thousands of babies.

When thalidomide was taken during pregnancy, particularly during a specific window of time in the first trimester, it caused startling birth malformations and death to babies. Any part of the fetus that was in development at the time of ingestion could be affected. For those babies who survived, birth defects included deafness, blindness, disfigurement, cleft palate, many other internal disabilities, and of course the disability most associated with thalidomide, phocomelia, as Mr. Bolton displays.

The numbers vary from source to source, as no proper census was ever taken, but it has been claimed that between 10,000 and 20,000 babies worldwide were born disabled as a consequence of the drug thalidomide. There are approximately 5,000 survivors alive today around the world. Never counted, and never to be known, was the number of babies miscarried or stillborn. Also never counted was the number of family members and parents who suffered over the years as they struggled with their conscience and the care of their affected children.

Around the world, in the late 1960s and into the early 1970s, the victims of the drug thalidomide, with their families, entered into class action legal suits or threatened actions against the various drug companies that manufactured and/or distributed the drug. They were eventually awarded settlements. In most countries, these settlements included monthly or annual payments based on the level of disability of the individual.

In Canada, the story was different. Canadian victims of the drug were forced to go it alone, family by family. No case ever reached a trial verdict. Rather, families were forced to settle out of court, with gag orders imposed on them not to discuss the amounts of their settlements.

It is startling to believe, but even today, as compensation is awarded to survivors, they are faced with gag orders on their compensation packages. The earlier gag order settlements resulted in a wide disparity in the compensation amounts, with settlements for individuals with the same levels of disability varying by hundreds of thousands of dollars.

In 1987, the War Amputations of Canada established the thalidomide task force to seek compensation for Canadian-born thalidomide survivors from the Government of Canada. As Canada allowed the drug into Canadian markets when many warnings were already available about side effects associated with thalidomide, and as Canada left the drug on the market a full three months after the majority of the world had withdrawn the drug, it was felt and argued that the Government of Canada had a moral responsibility to ensure that thalidomide survivors were properly compensated.

In 1991, the Department of National Health and Welfare, now Health Canada, through what was called an “extraordinary assistance plan”, awarded small compassionate lump sum financial assistance grants to Canadian-born thalidomide survivors. The lump sum payment was offered ex gratia, meaning that Ottawa recognized no legal liability in offering the money. The payout amounted to $8.5 million, which worked out to about $52,000 to $82,000 per victim, depending on the degree of disability. These payments were quickly used by those individuals to cover some of the extraordinary costs of their disabilities, and for most survivors these monies are long gone.

Thalidomide survivors are now in their mid-fifties, and they are experiencing physical deterioration due to stress placed on their different body structures, further limiting their abilities and often resulting in new disabilities as a result of degeneration of joints and limbs. This is compounding the tragedy. The needs and problems of this unique population are many and overwhelming, and that is adding to their day-to-day struggle to adapt and survive.

That is the background that brings us to the government's compensation offer in 2015.

It should be noted that as result of different appeals in Britain, nearly 470,000 thalidomide survivors now receive annual payments of about $88,000 each, from both the British government and the thalidomide drug distributor. In Germany, where the drug was first marketed, the federal government gives its 2,700 survivors pensions that total up to $110,000 a year.

Here in Canada, as a result of the 2015 compensation package offer introduced by then-health minister Rona Ambrose, each thalidomide victim was to receive a lump sum payment of $125,000 and an annual tax-free pension of $25,000, $75,000, or $100,000, depending on the severity of their condition, for the rest of their lives. As well, survivors are able to access a special $500,000 medical assistance fund to defray the cost of mobility devices and other adaptive tools they may need.

The outstanding issue, of course, is “the forgotten survivors”, as they prefer to call themselves. They are a small group of people, probably fewer than two dozen from that period—I'm almost finished, Mr. Chairman—

[The Chair, Liberal, Bill Casey]

I just want to explain. The minister has to leave now by prior arrangement. We arranged the timing to accommodate her—

[Gord Brown, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

The minister was going to be here till 10 o'clock. I have about one minute left, Mr. Chairman.

[The Chair, Liberal, Bill Casey]

—so she has to leave.

[Gord Brown, Conservative, Leeds—Grenville—Thousand Islands and Rideau Lakes, ON]

These are people like Mr. Bolton. After months of work trying to prove their case, they were rejected by a form letter sent to their homes. As I stated earlier, this is shameful, disgusting, and, quite frankly, embarrassing to all of us as parliamentarians and to Canada as a caring, compassionate nation.

The minister has refused to address the issue with Crawford, so I'm asking the minister, who is here, to look at this again. I'm also asking the committee to support this motion, use their independence to examine the issue, call these survivors as witnesses, call in the medical experts as witnesses, and decide how we can proceed to assist them. That, I believe, can be accomplished with a simple examination by a qualified professional.

Other countries accomplished this. Why can't Canada? These victims have endured a life of pain, suffering, discrimination, and lost opportunity. Let's not make another unhappy and depressing Christmas for these folks.

Thank you very much.